Provider Demographics
NPI:1225753908
Name:PHILIP D. KORENMAN MD
Entity Type:Organization
Organization Name:PHILIP D. KORENMAN MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:KORENMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-497-3454
Mailing Address - Street 1:4975 PRESTON PARK BLVD STE 130
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-3635
Mailing Address - Country:US
Mailing Address - Phone:214-497-3454
Mailing Address - Fax:972-985-2120
Practice Address - Street 1:4975 PRESTON PARK BLVD STE 130
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-3635
Practice Address - Country:US
Practice Address - Phone:214-497-3454
Practice Address - Fax:972-985-2120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-05
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty