| Envy IV, LLC | |
|
4070 State Hwy Suite 412 Carrollton TX 75010 | |
| (469) 216-1102 | |
| Not Available |
| Full Name | Envy IV, LLC |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 4070 State Hwy Suite 412, Carrollton, Texas |
| Authorized Official Name and Position | Jayoung Jeong (PROVIDER) |
| Authorized Official Contact | 4692161102 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Envy IV, LLC 12060 Bamberg Ln Frisco TX 75035-6991 Ph: (214) 404-6413 | Envy IV, LLC 4070 State Hwy Suite 412 Carrollton TX 75010 Ph: (469) 216-1102 |
| NPI Number | 1033982749 |
|---|---|
| Provider Enumeration Date | 11/03/2023 |
| Last Update Date | 04/30/2026 |
| Certification Date | 04/30/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033982749 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | () | Primary |
| 363L00000X | Nurse Practitioner | () | Secondary |
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