| Modoma Physical Medicine | |
|
5301 Village Creek Dr Suite B Plano TX 75093-4838 | |
| (972) 250-3443 | |
| Not Available |
| Full Name | Modoma Physical Medicine |
|---|---|
| Speciality | Clinic/center |
| Location | 5301 Village Creek Dr, Plano, Texas |
| Authorized Official Name and Position | Charles Demarque (MEDICAL DIRECTOR) |
| Authorized Official Contact | 8173088477 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Modoma Physical Medicine 4020 N Macarthur Blvd #122-286 Irving TX 75038-6419 Ph: () - | Modoma Physical Medicine 5301 Village Creek Dr Suite B Plano TX 75093-4838 Ph: (972) 250-3443 |
| NPI Number | 1538564018 |
|---|---|
| Provider Enumeration Date | 10/27/2014 |
| Last Update Date | 10/27/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538564018 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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