| Omega Heights Family Medicine Clinic Pllc | |
|
2730 Virginia Pkwy Suite 200 Mckinney TX 75071-5088 | |
| (214) 491-4900 | |
| (214) 491-4966 |
| Full Name | Omega Heights Family Medicine Clinic Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 2730 Virginia Pkwy, Mckinney, Texas |
| Authorized Official Name and Position | Nanette Icho (PRESIDENT) |
| Authorized Official Contact | 2144914900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Omega Heights Family Medicine Clinic Pllc 2730 Virginia Pkwy Suite 200 Mckinney TX 75071-5088 Ph: (214) 491-4900 | Omega Heights Family Medicine Clinic Pllc 2730 Virginia Pkwy Suite 200 Mckinney TX 75071-5088 Ph: (214) 491-4900 |
| NPI Number | 1003212440 |
|---|---|
| Provider Enumeration Date | 11/12/2014 |
| Last Update Date | 11/12/2014 |
| Medicare PECOS PAC ID | 9830415975 |
|---|---|
| Medicare Enrollment ID | O20150306001873 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003212440 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Texas) | Primary |
| 207QA0000X | Family Medicine - Adolescent Medicine | (Texas) | Secondary |
| 207QA0505X | Family Medicine - Adult Medicine | (Texas) | Secondary |
| Provider Name | Nanette A Icho |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467656918 PECOS PAC ID: 0749452795 Enrollment ID: I20111017000440 |
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