Provider Demographics
NPI:1619165917
Name:JENNIFER ORBEGOSO ATTMORE MDPA
Entity Type:Organization
Organization Name:JENNIFER ORBEGOSO ATTMORE MDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:ORBEGOSO
Authorized Official - Last Name:ATTMORE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-596-1803
Mailing Address - Street 1:3900 W 15TH ST
Mailing Address - Street 2:SUITE 404
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-7751
Mailing Address - Country:US
Mailing Address - Phone:972-596-1803
Mailing Address - Fax:972-867-4970
Practice Address - Street 1:3900 W 15TH ST
Practice Address - Street 2:SUITE 404
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-7751
Practice Address - Country:US
Practice Address - Phone:972-596-1803
Practice Address - Fax:972-867-4970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-11
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL5665261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1619165917OtherNPI
TX00Y176Medicare PIN
TX8F6174Medicare PIN
TX1619165917OtherNPI