Provider Demographics
NPI:1811231657
Name:PLANO CLINIC INC
Entity Type:Organization
Organization Name:PLANO CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:NEAGLE
Authorized Official - Suffix:IV
Authorized Official - Credentials:
Authorized Official - Phone:972-533-2716
Mailing Address - Street 1:5960 W PARKER RD
Mailing Address - Street 2:SUITE 278
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-7767
Mailing Address - Country:US
Mailing Address - Phone:972-533-2716
Mailing Address - Fax:
Practice Address - Street 1:5960 W PARKER RD
Practice Address - Street 2:SUITE 278
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-7767
Practice Address - Country:US
Practice Address - Phone:972-533-2716
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-17
Last Update Date:2012-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier