Provider Demographics
NPI:1790275394
Name:PHYSICIAN MEDICAL MANAGEMENT PARTNERS PLLC
Entity Type:Organization
Organization Name:PHYSICIAN MEDICAL MANAGEMENT PARTNERS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:903-868-0808
Mailing Address - Street 1:850 S GREENVILLE AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-5046
Mailing Address - Country:US
Mailing Address - Phone:972-765-2346
Mailing Address - Fax:972-848-0525
Practice Address - Street 1:3151 W 15TH ST
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-7731
Practice Address - Country:US
Practice Address - Phone:972-370-5771
Practice Address - Fax:972-674-2788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-18
Last Update Date:2018-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty