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NPI Code Detail

MEDICARE: PHYSICIANS MEDICAL CENTER, LLC

MEDICARE: PHYSICIANS MEDICAL CENTER, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1282N00000XGeneral Acute Care Hospital008153TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2HH1070OTHERTXBCBS PROVIDER NUMBER

General Provider Information

NPI Number : 1316933609
Entity Type Code : Organization
Provider Name (Legal Business Name) : PHYSICIANS MEDICAL CENTER, LLC
Provider Business Mailing Address
First Line : PO BOX 676266
Second Line :
City : DALLAS
State : TX
Zip : 75267-6266
Country : US
Telephone Number : 972-419-6704
Fax Number : 972-419-8188
Provider Business Practice Location Address
First Line : 6020 W PARKER RD
Second Line :
City : PLANO
State : TX
Zip : 75093-8171
Country : US
Telephone Number : 972-403-2700
Fax Number : 972-403-2852
Authorized Official
Title or Position : PRESIDENT
Name : MR. LARRY ROBERTSON
Credential :
Telephone Number : 972-403-2791
Provider Enumeration Date : 09/22/2005
Last Update Date : 11/03/2021

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Directions to “PHYSICIANS MEDICAL CENTER, LLC ” Practice Location

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