Clinic 21 of Collin County, PLLC

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

CLINIC 21 OF COLLIN COUNTY, PLLC

Practice address

5680 Frisco Square Blvd Ste 1200
Frisco, TX 75034-3300

Phone

(214) 618-8390

Fax

(214) 618-8419

NPI assigned

Mar 6, 2015

Organization subpart

No

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

Authorized official

Name

David Charles Packo, MDNPI 1497813281

Title

President

Phone

(330) 493-4443

Specialties & licenses 1

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Packo, MD

  • Emergency Medicine Physician
  • Massillon, OH
  • NPI 1497813281

  Emergency Medicine

  NPD (past) Authorized official
• Catherine E Carver, PA

  • Physician Assistant
  • Lubbock, TX
  • NPI 1841535499
  NPD (past)

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

{
    "created_epoch": "1425600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444003200000",
    "number": "1477946002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4535 DRESSLER RD NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182545",
            "telephone_number": "330-493-4443",
            "fax_number": "330-451-4142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5680 FRISCO SQUARE BLVD STE 1200",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750343300",
            "telephone_number": "214-618-8390",
            "fax_number": "214-618-8419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINIC 21 OF COLLIN COUNTY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-06",
        "last_updated": "2015-10-05",
        "status": "A",
        "authorized_official_last_name": "PACKO",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-493-4443",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madison Wray Clements, BCBA
• Amy Clifton, MS, CCC-SLP
• Richard Climer, LCSW
• Benjamin Luke Clinard, LMFT, LPC
• Lauren Sophia Cline, MD
• Tatia Close, LMFT
• Clough Dialysis LLC
• Clough Dialysis LLC
• Clover Family Medicine, PLLC
• Cobalt Counseling, LLC

• All providers in Frisco, TX
• Emergency Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2015; 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.