Organization
MEDINA PRIMARY CARE PLLC
Active
Other names
Medina Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
MIR MAJID ALI MD (PHYSICAN OWNER)
(972) 456-9292
Entity
Organization
Contact information
Practice address
4013 14TH ST, 401, PLANO, TX 75074-7125
(972) 456-9292
(972) 456-9393
Mailing address
4013 14TH ST, 401, PLANO, TX 75074-7125
(972) 456-9292
(972) 456-9393
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
Q6929
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
368903601
—
TX
Enumeration date
01/06/2017
Last updated
12/30/2019
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