| Modoma | |
|
4944 Preston Rd Ste 100a Frisco TX 75034-8987 | |
| (469) 304-3443 | |
| (469) 304-3443 |
| Full Name | Modoma |
|---|---|
| Speciality | Family Medicine |
| Location | 4944 Preston Rd Ste 100a, Frisco, Texas |
| Authorized Official Name and Position | Jason Marchetti (OWNER) |
| Authorized Official Contact | 4693043443 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Modoma 4944 Preston Rd Suite 100a Frisco TX 75034-8597 Ph: (469) 304-3443 | Modoma 4944 Preston Rd Ste 100a Frisco TX 75034-8987 Ph: (469) 304-3443 |
| NPI Number | 1265972772 |
|---|---|
| Provider Enumeration Date | 03/02/2017 |
| Last Update Date | 05/02/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265972772 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 208100000X | Physical Medicine & Rehabilitation | L7470 (Texas) | Secondary |
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