Provider Demographics
NPI:1689018459
Name:SORA LILY HEALTH CLINIC, PLLC
Entity Type:Organization
Organization Name:SORA LILY HEALTH CLINIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HELLEMN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-517-7226
Mailing Address - Street 1:280 LEGACY DR
Mailing Address - Street 2:STE 106
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-2376
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:280 LEGACY DR
Practice Address - Street 2:STE 106
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-2376
Practice Address - Country:US
Practice Address - Phone:972-555-1212
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-24
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care