| Texas Elite Health Clinic, Llc | |
|
1304 Village Creek Dr Suite 300-b Plano TX 75093-4472 | |
| (972) 402-9700 | |
| (972) 402-9706 |
| Full Name | Texas Elite Health Clinic, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1304 Village Creek Dr, Plano, Texas |
| Authorized Official Name and Position | Julie Kay Powell (FAMILY NURSE PRACTITIONER) |
| Authorized Official Contact | 9724029700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Texas Elite Health Clinic, Llc Po Box 116762 Carrollton TX 75011-6762 Ph: (972) 402-9700 | Texas Elite Health Clinic, Llc 1304 Village Creek Dr Suite 300-b Plano TX 75093-4472 Ph: (972) 402-9700 |
| NPI Number | 1033499967 |
|---|---|
| Provider Enumeration Date | 08/23/2011 |
| Last Update Date | 09/17/2012 |
| Medicare PECOS PAC ID | 0547435968 |
|---|---|
| Medicare Enrollment ID | O20111214000454 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033499967 | NPI | - | NPPES |
| 2971285-01 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 774439 (Texas) | Primary |
| Provider Name | Julie K Powell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467495465 PECOS PAC ID: 0042123309 Enrollment ID: I20111214000484 |
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