Provider Demographics
NPI:1215394473
Name:NORTH TEXAS MEDICAL CLINIC, PLLC
Entity Type:Organization
Organization Name:NORTH TEXAS MEDICAL CLINIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YAMUNA
Authorized Official - Middle Name:
Authorized Official - Last Name:GURRAPU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-888-2244
Mailing Address - Street 1:5350 INDEPENDENCE PKWY
Mailing Address - Street 2:STE 120
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035
Mailing Address - Country:US
Mailing Address - Phone:214-888-2244
Mailing Address - Fax:877-919-5871
Practice Address - Street 1:5350 INDEPENDENCE PKWY
Practice Address - Street 2:STE 120
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035
Practice Address - Country:US
Practice Address - Phone:214-888-2244
Practice Address - Fax:877-919-5871
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-19
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty