Provider Demographics
NPI:1508193251
Name:JOHN P CHEEK MDPA
Entity Type:Organization
Organization Name:JOHN P CHEEK MDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:DOMINGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-369-6411
Mailing Address - Street 1:8210 WALNUT HILL LN
Mailing Address - Street 2:SUITE 516
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4420
Mailing Address - Country:US
Mailing Address - Phone:214-369-6411
Mailing Address - Fax:214-361-7102
Practice Address - Street 1:8210 WALNUT HILL LN
Practice Address - Street 2:SUITE 516
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4420
Practice Address - Country:US
Practice Address - Phone:214-369-6411
Practice Address - Fax:214-361-7102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-17
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD3468207N00000X
TX207Q00000X, 207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC14407Medicare UPIN
TX0A5567Medicare PIN