Provider Demographics
NPI:1306893128
Name:QUESTCARE MEDICAL SERVICES PLLC
Entity type:Organization
Organization Name:QUESTCARE MEDICAL SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KONDAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-838-2371
Mailing Address - Street 1:13737 NOEL RD
Mailing Address - Street 2:#1600
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-1331
Mailing Address - Country:US
Mailing Address - Phone:954-838-2371
Mailing Address - Fax:
Practice Address - Street 1:12221 MERIT DR
Practice Address - Street 2:SUITE 1610
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75251-2202
Practice Address - Country:US
Practice Address - Phone:469-401-2386
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX119838402Medicaid
TXCD6603OtherMEDICARE RR
TX0088BHOtherBCBS
TXCD6602OtherMEDICARE RR
TX0023BMOtherBCBS
TX0087BHOtherBCBS
TX119838405Medicaid
TXCD4261OtherMEDICARE RR
TXDD9969OtherMEDICARE RR
TXCD6604OtherMEDICARE RR
TX119838403Medicaid
TX119838401Medicaid
TX119838406Medicaid
NM34357203Medicaid
TXCD4260OtherMEDICARE RR
TXCD6600OtherMEDICARE RR
TXCD4262OtherMEDICARE RR
TX119838405Medicaid
TX0087BHMedicare PIN
TX0088BHMedicare PIN