MEDICARE: MEDICLINKMD ONE-P 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
1	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1982097382
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICLINKMD ONE-P LLC

Provider Business Mailing Address
First Line	:	415 E SOUTHLAKE BLVD
Second Line	:	SUITE 100
City	:	SOUTHLAKE
State	:	TX
Zip	:	76092-6250
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	415 E SOUTHLAKE BLVD
Second Line	:	SUITE 100
City	:	SOUTHLAKE
State	:	TX
Zip	:	76092-6250
Country	:	US
Telephone Number	:	254-644-7898
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. ARTHUR HOHENBERGER
Credential	:
Telephone Number	:	254-644-7898

Provider Enumeration Date	:	03/09/2015
Last Update Date	:	03/09/2015

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