Organization
OM DATTA PLLC
Active
Parent organization
OM DATTA PLLC
Other names
TX Primary Care Plus
Organization subpart
Yes
Provider details
NPI number
Legal business name
OM DATTA PLLC
Authorized official
DR. VENKATESH MADHAV M.D (MANAGER)
(469) 476-7810
Entity
Organization
Contact information
Practice address
5040 TENNYSON PKWY, PLANO, TX 75024-3002
(469) 476-7810
(469) 574-7840
Mailing address
5040 TENNYSON PKWY, PLANO, TX 75024-3002
(469) 476-7810
(469) 574-7840
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
01/11/2019
Last updated
07/22/2021
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