Provider Demographics
NPI:1437806312
Name:BINNOUCEY MEDICAL CLINIC PLLC
Entity Type:Organization
Organization Name:BINNOUCEY MEDICAL CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KARLEEN
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:214-881-6572
Mailing Address - Street 1:2500 W PLEASANT RUN RD STE 200
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:TX
Mailing Address - Zip Code:75146-1170
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2500 W PLEASANT RUN RD STE 200
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:TX
Practice Address - Zip Code:75146-1170
Practice Address - Country:US
Practice Address - Phone:214-881-6572
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-09
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No163WG0000XNursing Service ProvidersRegistered NurseGeneral PracticeGroup - Multi-Specialty