Provider Demographics
NPI:1417403957
Name:TEXAS PHYSICIANS PRIMARY CARE, PLLC
Entity Type:Organization
Organization Name:TEXAS PHYSICIANS PRIMARY CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-986-5239
Mailing Address - Street 1:6110 DALROCK RD
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75088-4402
Mailing Address - Country:US
Mailing Address - Phone:972-526-5444
Mailing Address - Fax:
Practice Address - Street 1:2100 VIRGINIA ST
Practice Address - Street 2:SUITE G
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75051-3796
Practice Address - Country:US
Practice Address - Phone:972-264-2331
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-25
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty