| Your Medical Home, P.a. | |
|
101 S Coit Rd Ste 317 Richardson TX 75080-5743 | |
| (972) 437-9090 | |
| (972) 234-6474 |
| Full Name | Your Medical Home, P.a. |
|---|---|
| Speciality | Family Medicine |
| Location | 101 S Coit Rd, Richardson, Texas |
| Authorized Official Name and Position | Antoine R. Albert (PRESIDENT) |
| Authorized Official Contact | 9724379090 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Your Medical Home, P.a. 101 S Coit Rd Ste 317 Richardson TX 75080-5743 Ph: (972) 437-9090 | Your Medical Home, P.a. 101 S Coit Rd Ste 317 Richardson TX 75080-5743 Ph: (972) 437-9090 |
| NPI Number | 1033307020 |
|---|---|
| Provider Enumeration Date | 10/04/2007 |
| Last Update Date | 11/19/2014 |
| Medicare PECOS PAC ID | 2567535297 |
|---|---|
| Medicare Enrollment ID | O20080714000496 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033307020 | NPI | - | NPPES |
| 0009QQ | Other | TX | BCBS |
| C12654 | Other | UPIN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | G0932 (Texas) | Primary |
| Provider Name | Antoine R Albert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023043924 PECOS PAC ID: 1254314487 Enrollment ID: I20040609001181 |
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