Blue Diamond Physical Medicine | |
270 Redbud Blvd Ste 100 Mckinney TX 75069-3390 | |
(972) 542-5879 | |
(972) 542-7779 |
Full Name | Blue Diamond Physical Medicine |
---|---|
Speciality | Family Medicine |
Location | 270 Redbud Blvd, Mckinney, Texas |
Authorized Official Name and Position | James Lundin (STAFF PROVIDER) |
Authorized Official Contact | 9725425879 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Blue Diamond Physical Medicine 270 Redbud Blvd Ste 100 Mckinney TX 75069-3390 Ph: (972) 542-5879 | Blue Diamond Physical Medicine 270 Redbud Blvd Ste 100 Mckinney TX 75069-3390 Ph: (972) 542-5879 |
NPI Number | 1417390188 |
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Provider Enumeration Date | 04/12/2013 |
Last Update Date | 08/22/2022 |
Medicare PECOS PAC ID | 3375779309 |
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Medicare Enrollment ID | O20131122000724 |
Identifier | Type | State | Issuer |
---|---|---|---|
1417390188 | NPI | - | NPPES |
6953350001 | Other | TX | MEDICARE DMEPOS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
Provider Name | James W Lundin |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1841229291 PECOS PAC ID: 8729152046 Enrollment ID: I20131122001469 |
Provider Name | Adam A Rodriguez |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1841365269 PECOS PAC ID: 4284690652 Enrollment ID: I20170125000076 |
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