| King Family Medical Pllc | |
|
5750 Bunker Hill Rd Garland TX 75048 | |
| (972) 675-5300 | |
| (972) 675-5301 |
| Full Name | King Family Medical Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 5750 Bunker Hill Rd, Garland, Texas |
| Authorized Official Name and Position | Scott L King (OWNER/PRESIDENT) |
| Authorized Official Contact | 9726755300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| King Family Medical Pllc 5750 Bunker Hill Rd Garland TX 75048 Ph: (972) 675-5300 | King Family Medical Pllc 5750 Bunker Hill Rd Garland TX 75048 Ph: (972) 675-5300 |
| NPI Number | 1104164508 |
|---|---|
| Provider Enumeration Date | 01/21/2013 |
| Last Update Date | 10/02/2014 |
| Medicare PECOS PAC ID | 6002052487 |
|---|---|
| Medicare Enrollment ID | O20130410000376 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104164508 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | K8927 (Texas) | Primary |
| Provider Name | Scottie L King |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295759025 PECOS PAC ID: 0840466959 Enrollment ID: I20130411000292 |
| Provider Name | Mary E Diaz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205088754 PECOS PAC ID: 2668741745 Enrollment ID: I20170705002031 |
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