Organization
PREMIERCARE MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EKEOMA I. COOPER D-NURSE PRACTITIONER (DNP)
(972) 373-4191
Entity
Organization
Contact information
Practice address
6500 NORTHWEST DR STE 350, MESQUITE, TX 75150-1364
(972) 373-4191
(972) 373-4569
Mailing address
6500 NORTHWEST DR STE 350, MESQUITE, TX 75150-1364
(972) 373-4191
(972) 373-4569
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
408711601
—
TX
Enumeration date
08/30/2019
Last updated
05/25/2022
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