Provider Demographics
NPI:1801418637
Name:CONCIERGE TELEMEDICINE PLLC
Entity Type:Organization
Organization Name:CONCIERGE TELEMEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CHUKWUMA
Authorized Official - Middle Name:C
Authorized Official - Last Name:OSUAGWU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-985-2624
Mailing Address - Street 1:10847 SANDEN DR STE 102
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75238-5356
Mailing Address - Country:US
Mailing Address - Phone:214-985-2624
Mailing Address - Fax:
Practice Address - Street 1:10847 SANDEN DR STE 102
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75238-5356
Practice Address - Country:US
Practice Address - Phone:214-985-2624
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-14
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty