MEDICARE: PLANO SUPREME PRIMARY CARE 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
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1982046561
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLANO SUPREME PRIMARY CARE INC

Provider Business Mailing Address
First Line	:	4020 HEDGCOXE RD STE 700
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75024-7703
Country	:	US
Telephone Number	:	972-618-7800
Fax Number	:	972-618-7900

Provider Business Practice Location Address
First Line	:	4020 HEDGCOXE RD
Second Line	:	SUITE 700
City	:	PLANO
State	:	TX
Zip	:	75024-7700
Country	:	US
Telephone Number	:	972-213-0088
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	YINGHUI LIU
Credential	:	MD
Telephone Number	:	972-618-7800

Provider Enumeration Date	:	07/23/2013
Last Update Date	:	06/23/2026

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