Provider Demographics
NPI:1275931545
Name:SEASONS MEDICAL GROUP OF TEXAS, PLLC
Entity Type:Organization
Organization Name:SEASONS MEDICAL GROUP OF TEXAS, PLLC
Other - Org Name:ACCENTCARE MEDICAL GROUP OF TEXAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-692-1148
Mailing Address - Street 1:6400 SHAFER CT STE 300A
Mailing Address - Street 2:
Mailing Address - City:ROSEMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60018-4914
Mailing Address - Country:US
Mailing Address - Phone:847-692-1000
Mailing Address - Fax:
Practice Address - Street 1:6341 CAMPUS CIRCLE DR E STE 150
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-2712
Practice Address - Country:US
Practice Address - Phone:817-887-0017
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-18
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207QH0002X, 207RH0002X
TX207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Multi-Specialty
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Single Specialty