# PREMIERCARE MEDICAL CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346898418
- **Authorized official:** EKEOMA I. COOPER D-NURSE PRACTITIONER (DNP)
- **Authorized official phone:** (972) 373-4191

## Contact information

- **Practice address:** 6500 NORTHWEST DR STE 350, MESQUITE, TX 75150-1364
- **Practice address phone:** (972) 373-4191
- **Practice address fax:** (972) 373-4569
- **Mailing address:** 6500 NORTHWEST DR STE 350, MESQUITE, TX 75150-1364
- **Mailing address phone:** (972) 373-4191
- **Mailing address fax:** (972) 373-4569

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 08/30/2019
- **Last updated:** 05/25/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 408711601 | — | TX |