Provider Demographics
NPI:1922638725
Name:MEDCARE-PROFTX-75069
Entity Type:Organization
Organization Name:MEDCARE-PROFTX-75069
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:YARON
Authorized Official - Middle Name:
Authorized Official - Last Name:LOHR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-916-2929
Mailing Address - Street 1:15110 DALLAS PKWY STE 102
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-4601
Mailing Address - Country:US
Mailing Address - Phone:972-792-0204
Mailing Address - Fax:
Practice Address - Street 1:1505 HARROUN AVE STE 1
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-3433
Practice Address - Country:US
Practice Address - Phone:972-916-2929
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-21
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty