| Modoma | |
|
897 N Macarthur Blvd Suite 110 Coppell TX 75019-2705 | |
| (469) 304-3443 | |
| (469) 304-3443 |
| Full Name | Modoma |
|---|---|
| Speciality | Family Medicine |
| Location | 897 N Macarthur Blvd, Coppell, Texas |
| Authorized Official Name and Position | Grady Murphy (OWNER) |
| Authorized Official Contact | 4693043443 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Modoma 4944 Preston Rd Suite 100a Frisco TX 75034-8597 Ph: (469) 304-3443 | Modoma 897 N Macarthur Blvd Suite 110 Coppell TX 75019-2705 Ph: (469) 304-3443 |
| NPI Number | 1003356759 |
|---|---|
| Provider Enumeration Date | 02/28/2017 |
| Last Update Date | 02/28/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003356759 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | G3628 (* (Not Available)) | Primary |
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