Medstream Wellness Medical Group

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

MEDSTREAM WELLNESS MEDICAL GROUP

Practice address

1505 Harroun Ave Ste C
McKinney, TX 75069-3433

Phone

(469) 952-6400

Fax

(469) 952-6410

NPI assigned

Nov 24, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Vicki Blackmon Davis, M.D.

Title

Owmer

Phone

(469) 952-6400

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1290556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290556800000",
    "number": "1023310067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 HARROUN AVE STE C",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750693433",
            "telephone_number": "469-952-6400",
            "fax_number": "469-952-6410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 HARROUN AVE STE C",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750693433",
            "telephone_number": "469-952-6400",
            "fax_number": "469-952-6410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDSTREAM WELLNESS MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-24",
        "last_updated": "2010-11-24",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "VICKI",
        "authorized_official_middle_name": "BLACKMON",
        "authorized_official_title_or_position": "OWMER",
        "authorized_official_telephone_number": "469-952-6400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Medinatherapy PLLC
• Medrocs Corporation LLC
• Medrocs Corporation LLC
• Medspring of Texas, PA
• Medstream Healthcare Associates
• Medstream Wellness Medical Group
• Sherry Meeks, LPC
• Ellen Francine Cavalcanti Mehta, MSN, APRN, FNP-C
• Cindy Kay Mejia, RN
• Lauren Mekaowulu, LVN

• Internal Medicine Physician in McKinney, TX
• Providers in McKinney, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.