| Dmlc Medical Llc | |
|
1201 Richardson Dr Ste 100 Richardson TX 75080-4610 | |
| (972) 235-6311 | |
| Not Available |
| Full Name | Dmlc Medical Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1201 Richardson Dr Ste 100, Richardson, Texas |
| Authorized Official Name and Position | Cameron Zachary Olson (CEO) |
| Authorized Official Contact | 9722356311 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dmlc Medical Llc 1201 Richardson Dr Ste 100 Richardson TX 75080-4610 Ph: () - | Dmlc Medical Llc 1201 Richardson Dr Ste 100 Richardson TX 75080-4610 Ph: (972) 235-6311 |
| NPI Number | 1538742887 |
|---|---|
| Provider Enumeration Date | 05/04/2021 |
| Last Update Date | 08/06/2023 |
| Medicare PECOS PAC ID | 0244630606 |
|---|---|
| Medicare Enrollment ID | O20210608000019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538742887 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Matthew Bruce Roberson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871590570 PECOS PAC ID: 8426158965 Enrollment ID: I20070712000313 |
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