| Md Request Pllc | |
|
4645 Avon Ln Ste 200 Frisco TX 75033-1559 | |
| (469) 430-5850 | |
| (877) 722-7085 |
| Full Name | Md Request Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 4645 Avon Ln Ste 200, Frisco, Texas |
| Authorized Official Name and Position | Jordan Pastorek (PRESIDENT/OWNER) |
| Authorized Official Contact | 4694305850 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Md Request Pllc 4645 Avon Ln Ste 200 Frisco TX 75033-1559 Ph: (469) 430-5850 | Md Request Pllc 4645 Avon Ln Ste 200 Frisco TX 75033-1559 Ph: (469) 430-5850 |
| NPI Number | 1316281975 |
|---|---|
| Provider Enumeration Date | 11/20/2012 |
| Last Update Date | 03/23/2023 |
| Medicare PECOS PAC ID | 8325285547 |
|---|---|
| Medicare Enrollment ID | O20130508000016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316281975 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Jordan M Pastorek |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265400634 PECOS PAC ID: 2163498569 Enrollment ID: I20051117001021 |
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