Provider Demographics
NPI:1134406028
Name:PLAZA MEDICAL CENTER
Entity type:Organization
Organization Name:PLAZA MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERNAL MEDICINE RESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BHOOMI
Authorized Official - Middle Name:HIRALAL
Authorized Official - Last Name:SUTARIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-658-4719
Mailing Address - Street 1:6704 MEADE DR
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-5775
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6704 MEADE DR
Practice Address - Street 2:
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-5775
Practice Address - Country:US
Practice Address - Phone:972-658-4719
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-07
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital