| Advanced Family Medical Care Pa | |
|
4002 W Park Blvd Plano TX 75093-3839 | |
| (972) 985-8000 | |
| Not Available |
| Full Name | Advanced Family Medical Care Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 4002 W Park Blvd, Plano, Texas |
| Authorized Official Name and Position | Ahtaram Khan (OWNER) |
| Authorized Official Contact | 9729858000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Family Medical Care Pa Po Box 262129 Plano TX 75026-2129 Ph: () - | Advanced Family Medical Care Pa 4002 W Park Blvd Plano TX 75093-3839 Ph: (972) 985-8000 |
| NPI Number | 1508047416 |
|---|---|
| Provider Enumeration Date | 11/19/2007 |
| Last Update Date | 02/05/2013 |
| Medicare PECOS PAC ID | 2860476835 |
|---|---|
| Medicare Enrollment ID | O20040616001155 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508047416 | NPI | - | NPPES |
| DB0572 | Other | TX | MEDICARE B - RAIL ROAD |
| 0051HA | Other | TX | BLUE CROSS BLUE SHIELD |
| 157608401 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MDL1628 (Texas) | Primary |
| Provider Name | Ahtaram M Khan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336258003 PECOS PAC ID: 1557345535 Enrollment ID: I20120718000083 |
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