Provider Demographics
NPI:1104204049
Name:ESTEEM MEDICAL MANAGEMENT, LLC
Entity Type:Organization
Organization Name:ESTEEM MEDICAL MANAGEMENT, LLC
Other - Org Name:ESTEEM HOUSE CALL PHYSICIANS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:MERCHANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-239-8131
Mailing Address - Street 1:2459 E HEBRON PKWY
Mailing Address - Street 2:STE 130
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-4482
Mailing Address - Country:US
Mailing Address - Phone:972-239-8131
Mailing Address - Fax:972-239-8183
Practice Address - Street 1:2459 E HEBRON PKWY
Practice Address - Street 2:STE 130
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-4482
Practice Address - Country:US
Practice Address - Phone:972-239-8131
Practice Address - Fax:972-239-8183
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ESTEEM HEALTHCARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-05-12
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty