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Organization
WILLOW BEND FAMILY MEDICINE P.A.
Active
Organization
WILLOW BEND FAMILY MEDICINE P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAWN OR THAO PERKINS OR TONG (BILLING OFFICE)
(972) 981-7000
Entity
Organization
Contact information
Practice address
6124 W PARKER RD STE 138, PLANO, TX 75093-8124
(972) 981-7000
Mailing address
6124 W PARKER RD STE 138, PLANO, TX 75093-8124
(972) 981-7000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
H2316
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00478N
MEDICARE PTIN
TX
Enumeration date
05/31/2007
Last updated
09/02/2008
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