Provider Demographics
NPI:1952828279
Name:NORTH DALLAS PRIMARY CARE DOCTORS PLLC
Entity Type:Organization
Organization Name:NORTH DALLAS PRIMARY CARE DOCTORS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUCHITRA
Authorized Official - Middle Name:RAO
Authorized Official - Last Name:KAMINENI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-705-3728
Mailing Address - Street 1:8795 PRESTON TRACE BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-3010
Mailing Address - Country:US
Mailing Address - Phone:214-705-3728
Mailing Address - Fax:214-308-9464
Practice Address - Street 1:8795 PRESTON TRACE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-3010
Practice Address - Country:US
Practice Address - Phone:214-705-3728
Practice Address - Fax:214-308-9464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-28
Last Update Date:2023-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP0418207R00000X, 207RH0002X
TXN8163208000000X, 2080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Single Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
No2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal MedicineGroup - Single Specialty