Provider Demographics
NPI:1114705308
Name:PREMIER HEALTHCARE SPECIALISTS
Entity Type:Organization
Organization Name:PREMIER HEALTHCARE SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:WEBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-251-9851
Mailing Address - Street 1:718 N EAST ST # 270
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75090-4724
Mailing Address - Country:US
Mailing Address - Phone:903-251-9851
Mailing Address - Fax:
Practice Address - Street 1:181 N RIDGE RD STE 200
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-6962
Practice Address - Country:US
Practice Address - Phone:903-251-9851
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-19
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty