Provider Demographics
NPI:1477154672
Name:PKMD ENTERPRISES, INC
Entity type:Organization
Organization Name:PKMD ENTERPRISES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:PRESTON
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:214-803-1108
Mailing Address - Street 1:1918 UNIVERSITY BUSINESS DR STE 505
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-5805
Mailing Address - Country:US
Mailing Address - Phone:469-461-1515
Mailing Address - Fax:888-423-0215
Practice Address - Street 1:201 COLONNADE PKWY STE 101
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-6174
Practice Address - Country:US
Practice Address - Phone:254-307-0128
Practice Address - Fax:888-423-0215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-04
Last Update Date:2023-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier