MEDICARE: KAMCARE PLLC

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
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1366184137
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KAMCARE PLLC

Provider Business Mailing Address
First Line	:	5056 TENNYSON PKWY STE 200
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75024-2922
Country	:	US
Telephone Number	:	972-372-9590
Fax Number	:

Provider Business Practice Location Address
First Line	:	5056 TENNYSON PKWY STE 200
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75024-2922
Country	:	US
Telephone Number	:	972-372-9590
Fax Number	:	972-372-9415

Authorized Official
Title or Position	:	FNP/OWNER
Name	:	KATHERINE HEYDE
Credential	:	FNP
Telephone Number	:	972-372-9590

Provider Enumeration Date	:	04/11/2022
Last Update Date	:	06/16/2022

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