Provider Demographics
NPI:1811526874
Name:DRIVEN MD, PLLC
Entity type:Organization
Organization Name:DRIVEN MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DE MOOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-494-0177
Mailing Address - Street 1:6991 PECAN ST. SUITE 300 # W302
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-4252
Mailing Address - Country:US
Mailing Address - Phone:469-902-9200
Mailing Address - Fax:214-975-2429
Practice Address - Street 1:6991 PECAN ST. SUITE 300 # W302
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-4252
Practice Address - Country:US
Practice Address - Phone:469-902-9200
Practice Address - Fax:214-975-2429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-02
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No251E00000XAgenciesHome HealthGroup - Multi-Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX412317601Medicaid
45D2184805OtherCLIA