| Itinerant Primary Care | |
|
4300 N Central Expy Ste 235 Dallas TX 75206-6570 | |
| (469) 615-5896 | |
| (817) 585-4029 |
| Full Name | Itinerant Primary Care |
|---|---|
| Speciality | General Practice |
| Location | 4300 N Central Expy Ste 235, Dallas, Texas |
| Authorized Official Name and Position | Christopher Ray Chumley (CMO) |
| Authorized Official Contact | 2144039200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Itinerant Primary Care 4300 N Central Expy Ste 235 Dallas TX 75206-6570 Ph: (469) 615-5896 | Itinerant Primary Care 4300 N Central Expy Ste 235 Dallas TX 75206-6570 Ph: (469) 615-5896 |
| NPI Number | 1346839859 |
|---|---|
| Provider Enumeration Date | 01/11/2021 |
| Last Update Date | 11/16/2022 |
| Medicare PECOS PAC ID | 2062827678 |
|---|---|
| Medicare Enrollment ID | O20210212000168 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346839859 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Michael D Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184628067 PECOS PAC ID: 0244246684 Enrollment ID: I20060222000776 |
| Provider Name | Kristina Simic Parsons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336338565 PECOS PAC ID: 3577641539 Enrollment ID: I20080417000078 |
| Provider Name | Christopher Ray Chumley |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1982803664 PECOS PAC ID: 0749328375 Enrollment ID: I20091118000644 |
| Provider Name | Kimberly L Kammerer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033690839 PECOS PAC ID: 4981032471 Enrollment ID: I20200316002267 |
| Provider Name | Crystal B Kronenberger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558690719 PECOS PAC ID: 8527346758 Enrollment ID: I20201002001987 |
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