# PLEASANT GROVE FAMILY MEDICAL CLINIC, PA

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

## Provider details

- **NPI number:** 1417915125
- **Authorized official:** DR. MICHAEL D HOFFMAN DO (OWNER/PHYSICIAN)
- **Authorized official phone:** (214) 358-0090

## Contact information

- **Practice address:** 2959 S BUCKNER BLVD, STE 700, DALLAS, TX 75227-6945
- **Practice address phone:** (214) 206-4974
- **Practice address fax:** (214) 206-4979
- **Mailing address:** 9991 MARSH LN, DALLAS, TX 75220-1766
- **Mailing address phone:** (214) 358-0090
- **Mailing address fax:** (214) 526-6851

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/02/2006
- **Last updated:** 04/09/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 178058703 | — | TX |