Provider Demographics
NPI:1679250120
Name:PATIENT-PHYSICIAN NETWORK
Entity Type:Organization
Organization Name:PATIENT-PHYSICIAN NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CCSA
Authorized Official - Prefix:MRS
Authorized Official - First Name:DENITA
Authorized Official - Middle Name:GAYLE
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:CCSA
Authorized Official - Phone:469-626-1727
Mailing Address - Street 1:5151 HEADQUARTERS DR STE 220
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-0020
Mailing Address - Country:US
Mailing Address - Phone:469-626-1727
Mailing Address - Fax:
Practice Address - Street 1:5151 HEADQUARTERS DR STE 220
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-0020
Practice Address - Country:US
Practice Address - Phone:469-626-1727
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PATIENT-PHYSICIAN NETWORK
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-06-28
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty