Provider Demographics
NPI:1750043295
Name:COVIDEMT CLINICS PLLC
Entity Type:Organization
Organization Name:COVIDEMT CLINICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:FINGEROTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-873-5091
Mailing Address - Street 1:4740 14TH ST # 324
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-7316
Mailing Address - Country:US
Mailing Address - Phone:972-422-7733
Mailing Address - Fax:
Practice Address - Street 1:17980 DALLAS PKWY STE 300
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75287-6817
Practice Address - Country:US
Practice Address - Phone:972-878-3945
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-12
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty