Provider Demographics
NPI:1346788346
Name:DOCTORS OF PRIMARY CARE AT MCKINNEY
Entity Type:Organization
Organization Name:DOCTORS OF PRIMARY CARE AT MCKINNEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LADAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKHTARI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-280-2400
Mailing Address - Street 1:240 ADRIATIC PARKWAY
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070
Mailing Address - Country:US
Mailing Address - Phone:972-382-9292
Mailing Address - Fax:972-992-3937
Practice Address - Street 1:240 ADRIATIC PARKWAY
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070
Practice Address - Country:US
Practice Address - Phone:972-382-9292
Practice Address - Fax:972-992-3937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-09
Last Update Date:2018-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8447207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty