MEDICARE: CORE FAMILY CARE CLINIC

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	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1538866629
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORE FAMILY CARE CLINIC

Provider Business Mailing Address
First Line	:	4500 HILLCREST RD STE 185
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75035-5401
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4500 HILLCREST RD STE 185
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75035-5401
Country	:	US
Telephone Number	:	305-479-7945
Fax Number	:

Authorized Official
Title or Position	:	MANAGER/OWNER
Name	:	DR. IKECHUKWU OKORIE
Credential	:	MD
Telephone Number	:	305-479-7945

Provider Enumeration Date	:	02/09/2023
Last Update Date	:	03/23/2023

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Directions to “CORE FAMILY CARE CLINIC ” Practice Location

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