| Pac Of Dallas Pllc | |
|
5041 Charles Pl Plano TX 75093-7531 | |
| (972) 989-1118 | |
| (972) 590-9962 |
| Full Name | Pac Of Dallas Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 5041 Charles Pl, Plano, Texas |
| Authorized Official Name and Position | Mustafa Sardini (OWNER) |
| Authorized Official Contact | 2146000050 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pac Of Dallas Pllc 5041 Charles Pl Plano TX 75093-7531 Ph: (972) 989-1118 | Pac Of Dallas Pllc 5041 Charles Pl Plano TX 75093-7531 Ph: (972) 989-1118 |
| NPI Number | 1750060380 |
|---|---|
| Provider Enumeration Date | 07/12/2023 |
| Last Update Date | 07/12/2023 |
| Medicare PECOS PAC ID | 8426411232 |
|---|---|
| Medicare Enrollment ID | O20230828000780 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750060380 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Mustafa Sardini |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891979175 PECOS PAC ID: 8628136041 Enrollment ID: I20081028000843 |
| Provider Name | Tracy Jennifer Hernandez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316158652 PECOS PAC ID: 4385704808 Enrollment ID: I20081113000434 |
| Provider Name | Sepehr Daheshpour |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1578909164 PECOS PAC ID: 1355696865 Enrollment ID: I20180622002249 |
| Provider Name | Nickalaus Phillip Swan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265962500 PECOS PAC ID: 1254694458 Enrollment ID: I20181219002992 |
| Provider Name | Abdulatif Adnan Jabi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609063734 PECOS PAC ID: 6800940792 Enrollment ID: I20200106001101 |
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