| Richardson Primarycare Clinic Llc | |
|
2821 E President George Bush Hwy Suite 301 Richardson TX 75082-4266 | |
| (972) 437-9210 | |
| (972) 437-9240 |
| Full Name | Richardson Primarycare Clinic Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2821 E President George Bush Hwy, Richardson, Texas |
| Authorized Official Name and Position | Mohammad Amir (OWNER) |
| Authorized Official Contact | 9724379210 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Richardson Primarycare Clinic Llc 2821 E President George Bush Hwy Suite 301 Richardson TX 75082-4266 Ph: (972) 437-9210 | Richardson Primarycare Clinic Llc 2821 E President George Bush Hwy Suite 301 Richardson TX 75082-4266 Ph: (972) 437-9210 |
| NPI Number | 1871774786 |
|---|---|
| Provider Enumeration Date | 11/19/2007 |
| Last Update Date | 11/19/2014 |
| Medicare PECOS PAC ID | 1052373073 |
|---|---|
| Medicare Enrollment ID | O20041102000530 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871774786 | NPI | - | NPPES |
| 0008MA | Other | TX | BLUE CROSS BLUE SHIELD |
| 170187201 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | K0604 (Texas) | Primary |
| Provider Name | Mohammad Amir |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265443857 PECOS PAC ID: 9739141755 Enrollment ID: I20041110001290 |
| Provider Name | Jamie Xuan Le |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073104576 PECOS PAC ID: 1456766567 Enrollment ID: I20210224000553 |
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