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NPI Code Detail

MEDICARE: PREMIER INDEPENDENT PHYSICIANS GROUP, INC.

MEDICARE: PREMIER INDEPENDENT PHYSICIANS GROUP, INC.
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
1207R00000XInternal Medicine Physician
2261QM0850XAdult Mental Health Clinic/Center
3251S00000XCommunity/Behavioral Health Agency
4208800000XUrology Physician
5207RE0101XEndocrinology, Diabetes & Metabolism Physician
6207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1437676640
Entity Type Code : Organization
Provider Name (Legal Business Name) : PREMIER INDEPENDENT PHYSICIANS GROUP, INC.
Provider Business Mailing Address
First Line : 2871 LAKE VISTA DR STE 210
Second Line :
City : LEWISVILLE
State : TX
Zip : 75067-8411
Country : US
Telephone Number : 940-442-5209
Fax Number : 940-222-2720
Provider Business Practice Location Address
First Line : 1512 TEASLEY LN
Second Line :
City : DENTON
State : TX
Zip : 76205-7282
Country : US
Telephone Number : 940-442-5209
Fax Number : 940-222-2720
Authorized Official
Title or Position : COO
Name : CAROL NGUYEN
Credential :
Telephone Number : 940-442-5209
Provider Enumeration Date : 08/28/2017
Last Update Date : 01/12/2026

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Directions to “PREMIER INDEPENDENT PHYSICIANS GROUP, INC. ” Practice Location

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