Centennial Primary Care Pllc | |
5520 Independence Pkwy Suite 201 Frisco TX 75035-4606 | |
(214) 383-0001 | |
(214) 383-0068 |
Full Name | Centennial Primary Care Pllc |
---|---|
Speciality | Internal Medicine |
Location | 5520 Independence Pkwy, Frisco, Texas |
Authorized Official Name and Position | Nuzhat F Ahmed (MANAGING DIRECTOR) |
Authorized Official Contact | 5126561050 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Centennial Primary Care Pllc 5520 Independence Pkwy Suite 201 Frisco TX 75035-4606 Ph: (214) 383-0001 | Centennial Primary Care Pllc 5520 Independence Pkwy Suite 201 Frisco TX 75035-4606 Ph: (214) 383-0001 |
NPI Number | 1831458132 |
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Provider Enumeration Date | 05/08/2012 |
Last Update Date | 07/21/2012 |
Medicare PECOS PAC ID | 4688830003 |
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Medicare Enrollment ID | O20120730000163 |
Identifier | Type | State | Issuer |
---|---|---|---|
1831458132 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | K3664 (Texas) | Primary |
Provider Name | Nuzhat Fatima Ahmed |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1275517799 PECOS PAC ID: 6305974973 Enrollment ID: I20100503000695 |
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