Provider Demographics
NPI:1528249992
Name:PLANO PRIMARY CARE CLINIC PA
Entity type:Organization
Organization Name:PLANO PRIMARY CARE CLINIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:MOIN
Authorized Official - Last Name:FAROOQI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-398-8161
Mailing Address - Street 1:4101 W SPRING CREEK PKWY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-5307
Mailing Address - Country:US
Mailing Address - Phone:972-398-8161
Mailing Address - Fax:972-398-8121
Practice Address - Street 1:4101 W SPRING CREEK PKWY
Practice Address - Street 2:SUITE 300
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-5307
Practice Address - Country:US
Practice Address - Phone:972-398-8161
Practice Address - Fax:972-398-8121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-14
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4055207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00675NOtherMEDICARE
TX0028EEOtherBLUE CROSS BLUE SHIELD
TX080985701Medicaid