| Texas Physicians Specialized Medicine Pllc | |
|
3401 W Airport Fwy Suite 101 Irving TX 75062-5902 | |
| (214) 596-1051 | |
| (214) 596-1052 |
| Full Name | Texas Physicians Specialized Medicine Pllc |
|---|---|
| Speciality | General Practice |
| Location | 3401 W Airport Fwy, Irving, Texas |
| Authorized Official Name and Position | Jason Albert Kouri (OWNER) |
| Authorized Official Contact | 2145961051 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Texas Physicians Specialized Medicine Pllc 3401 W Airport Fwy Suite 101 Irving TX 75062-5902 Ph: (214) 596-1051 | Texas Physicians Specialized Medicine Pllc 3401 W Airport Fwy Suite 101 Irving TX 75062-5902 Ph: (214) 596-1051 |
| NPI Number | 1619373453 |
|---|---|
| Provider Enumeration Date | 11/06/2014 |
| Last Update Date | 03/11/2022 |
| Medicare PECOS PAC ID | 3779807250 |
|---|---|
| Medicare Enrollment ID | O20150112001523 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619373453 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | P3183 (Texas) | Primary |
| Provider Name | Anis R Noorani |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1144248790 PECOS PAC ID: 3072510262 Enrollment ID: I20061101000079 |
| Provider Name | Lisa A Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952619967 PECOS PAC ID: 7517144694 Enrollment ID: I20110527000440 |
| Provider Name | Jason A Kouri |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649276965 PECOS PAC ID: 8820036395 Enrollment ID: I20130222000207 |
| Provider Name | Ashley Nicole Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003698937 PECOS PAC ID: 8123464179 Enrollment ID: I20240312003818 |
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