Provider Demographics
NPI:1568581718
Name:UMAR LATIF MD PA
Entity Type:Organization
Organization Name:UMAR LATIF MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:UMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:LATIF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:940-365-5711
Mailing Address - Street 1:5999 CUSTER RD # 110-355
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-9302
Mailing Address - Country:US
Mailing Address - Phone:940-365-5711
Mailing Address - Fax:940-365-5722
Practice Address - Street 1:8800 US HIGHWAY 380
Practice Address - Street 2:SUITE 600
Practice Address - City:CROSS ROADS
Practice Address - State:TX
Practice Address - Zip Code:76227
Practice Address - Country:US
Practice Address - Phone:940-365-5711
Practice Address - Fax:940-365-5722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM11972084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty