| Usamdt Plano | |
|
5700 Tennyson Pkwy Ste 300 Plano TX 75024-3595 | |
| (469) 573-0547 | |
| (800) 729-5406 |
| Full Name | Usamdt Plano |
|---|---|
| Speciality | Clinic/Center |
| Location | 5700 Tennyson Pkwy Ste 300, Plano, Texas |
| Authorized Official Name and Position | Joslyn Maree Tatum (PARTNER) |
| Authorized Official Contact | 4695730547 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Usamdt Plano 5700 Tennyson Pkwy Ste 300 Plano TX 75024-3595 Ph: (469) 573-0547 | Usamdt Plano 5700 Tennyson Pkwy Ste 300 Plano TX 75024-3595 Ph: (469) 573-0547 |
| NPI Number | 1386236800 |
|---|---|
| Provider Enumeration Date | 02/05/2021 |
| Last Update Date | 10/13/2021 |
| Medicare PECOS PAC ID | 0840698387 |
|---|---|
| Medicare Enrollment ID | O20220910000084 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386236800 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Michael J Bauer |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1346417086 PECOS PAC ID: 4688729858 Enrollment ID: I20220516001556 |
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