Provider Demographics
NPI:1346554284
Name:TRAVELING PHYSICIANS NETWORK
Entity Type:Organization
Organization Name:TRAVELING PHYSICIANS NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:B
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:469-619-3080
Mailing Address - Street 1:2831 ELDORADO PKWY STE 103-303
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-7438
Mailing Address - Country:US
Mailing Address - Phone:469-619-3080
Mailing Address - Fax:469-252-3509
Practice Address - Street 1:1505 HARROUN AVE
Practice Address - Street 2:STE C
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-3432
Practice Address - Country:US
Practice Address - Phone:469-619-3080
Practice Address - Fax:469-252-3509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-03
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty