Provider Demographics
NPI:1396922050
Name:MCKINNEY COMPREHENSIVE CARE
Entity type:Organization
Organization Name:MCKINNEY COMPREHENSIVE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:V.P./SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:ROY
Authorized Official - Middle Name:A
Authorized Official - Last Name:SETZENFAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-540-6256
Mailing Address - Street 1:4510 MEDICAL CENTER DR
Mailing Address - Street 2:TBD
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-1650
Mailing Address - Country:US
Mailing Address - Phone:972-540-6256
Mailing Address - Fax:972-540-5071
Practice Address - Street 1:4510 MEDICAL CENTER DR
Practice Address - Street 2:TBD
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-1650
Practice Address - Country:US
Practice Address - Phone:972-540-6256
Practice Address - Fax:972-540-5071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-24
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL8947207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG59597Medicare UPIN
TXI35317Medicare UPIN