Organization · NPI-2

Denton Professional Medical Group,pllc

· Denton, TX

NPI number1821225772
StatusActive
Last updated in NPPESJun 18, 2009

Details

NPI
1821225772
Entity type
Organization (NPI-2)
Legal business name
Denton Professional Medical Group,pllc
Organization subpart
No
Enumeration date
Jun 18, 2009
Last updated
Jun 18, 2009

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208VP0000X OS5264FLYes

Practice location

3201 Colorado Blvd
Denton, TX 76210-6863

Phone 940-381-0885 · Fax 940-380-0382

Mailing address

3201 Colorado Blvd
Denton, TX 76210-6863

Phone 940-381-0885 · Fax 940-380-0382

Authorized official

Michael Flicker
Managing Member
9403810885

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