Provider Demographics
NPI:1033462221
Name:QUESTCARE SPECIALTY OBSTETRICS, PLLC
Entity Type:Organization
Organization Name:QUESTCARE SPECIALTY OBSTETRICS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DELEGATED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LIEBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-217-1911
Mailing Address - Street 1:PO BOX 678644
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75267-8644
Mailing Address - Country:US
Mailing Address - Phone:214-217-1911
Mailing Address - Fax:214-217-1912
Practice Address - Street 1:500 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75057-3641
Practice Address - Country:US
Practice Address - Phone:214-217-1911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-25
Last Update Date:2012-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX307603601Medicaid