Immaculate Conception Health Services LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

IMMACULATE CONCEPTION HEALTH SERVICES LLC

Practice address

2105 W Spring Creek Pkwy Ste 320
Plano, TX 75023-4566

Phone

(423) 933-5223

Fax

(682) 270-0116

NPI assigned

Aug 9, 2021

Organization subpart

No

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

Authorized official

Name

Jagruti Raj

Title

Owner

Phone

(423) 933-5223

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1628467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685059200000",
    "number": "1639844954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 W SPRING CREEK PKWY STE 320",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750234566",
            "telephone_number": "423-933-5223",
            "fax_number": "682-270-0116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 W SPRING CREEK PKWY STE 320",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750234566",
            "telephone_number": "423-933-5223",
            "fax_number": "682-270-0116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMMACULATE CONCEPTION HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-09",
        "last_updated": "2023-05-26",
        "certification_date": "2023-05-26",
        "status": "A",
        "authorized_official_last_name": "RAJ",
        "authorized_official_first_name": "JAGRUTI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-933-5223"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Plano, TX
• Providers in Plano, TX by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2023; 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.