Diverse Medical Management, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

000765200 Issued in TX

Legal business name

DIVERSE MEDICAL MANAGEMENT, INC.

Doing business as

DMMI, Inc.

Practice address

5021 Trail Lake Dr
Plano, TX 75093-7530

Phone

(931) 409-4350

NPI assigned

Feb 8, 2018

Organization subpart

Yes

Parent organization

DIVERSE MEDICAL MANAGEMENT, INC.As reported in NPPES

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

Authorized official

Name

Michael Frey

Title

Ceo

Phone

(931) 409-4350

Specialties & licenses 2

Addresses

Other names 1

• DMMI, Inc. Doing business as

Part of

Diverse Medical Management

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

{
    "created_epoch": "1518048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518048000000",
    "number": "1346749942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 BECKRIDGE RD",
            "city": "MCMINNVILLE",
            "state": "TN",
            "postal_code": "371105006",
            "telephone_number": "931-409-4350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5021 TRAIL LAKE DR",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750937530",
            "telephone_number": "931-409-4350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERSE MEDICAL MANAGEMENT, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DIVERSE MEDICAL MANAGEMENT, INC.",
        "enumeration_date": "2018-02-08",
        "last_updated": "2018-02-08",
        "status": "A",
        "authorized_official_last_name": "FREY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "931-409-4350"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "000765200",
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "TX",
            "license": "000765200",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DMMI, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Medicine Physician in Plano, TX
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• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2018; 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.