Vitalsfusion Primary Care Pllc | |
940 W Stacy Rd Ste 110 Allen TX 75013-5215 | |
(773) 710-8081 | |
Not Available |
Full Name | Vitalsfusion Primary Care Pllc |
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Speciality | Family Medicine |
Location | 940 W Stacy Rd Ste 110, Allen, Texas |
Authorized Official Name and Position | Fakhrudin A Mohamed (OWNER) |
Authorized Official Contact | 7737108081 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Vitalsfusion Primary Care Pllc 940 W Stacy Rd Ste 110 Allen TX 75013-5215 Ph: (773) 710-8081 | Vitalsfusion Primary Care Pllc 940 W Stacy Rd Ste 110 Allen TX 75013-5215 Ph: (773) 710-8081 |
NPI Number | 1427706480 |
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Provider Enumeration Date | 03/17/2022 |
Last Update Date | 03/17/2022 |
Medicare PECOS PAC ID | 9638565542 |
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Medicare Enrollment ID | O20220401000368 |
Identifier | Type | State | Issuer |
---|---|---|---|
1427706480 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Fakhrudin Aaseemah Mohamed |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1952782518 PECOS PAC ID: 4688924491 Enrollment ID: I20191014001718 |
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