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2200 W Spring Creek Parkway Suite B Plano TX 75023-4500 | |
| (972) 599-1314 | |
| (972) 599-1227 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 2200 W Spring Creek Parkway, Plano, Texas |
| Authorized Official Name and Position | Linda W Tidmore (BUSINESS MANAGER) |
| Authorized Official Contact | 9725967255 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2200 W Spring Creek Parkway Suite B Plano TX 75023-4500 Ph: (972) 599-1314 | 2200 W Spring Creek Parkway Suite B Plano TX 75023-4500 Ph: (972) 599-1314 |
| NPI Number | 1285775635 |
|---|---|
| Provider Enumeration Date | 02/09/2007 |
| Last Update Date | 08/17/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285775635 | NPI | - | NPPES |
| 041872501 | Medicaid | TX | |
| 00J362 | Other | TX | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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