Elite Family Health of Plano, PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

ELITE FAMILY HEALTH OF PLANO, PLLC

Practice address

2595 Dallas Pkwy
Suite 403
Frisco, TX 75034-8527

Phone

(469) 362-8282

Fax

(469) 362-8283

NPI assigned

Apr 28, 2008

Organization subpart

No

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

Authorized official

Name

Jeff Henderson

Title

President

Phone

(615) 373-7600

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1209340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222732800000",
    "number": "1679748834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2595 DALLAS PKWY",
            "address_2": "SUITE 403",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750348527",
            "telephone_number": "469-362-8282",
            "fax_number": "469-362-8283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2595 DALLAS PKWY",
            "address_2": "SUITE 403",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750348527",
            "telephone_number": "469-362-8282",
            "fax_number": "469-362-8283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE FAMILY HEALTH OF PLANO, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-28",
        "last_updated": "2008-09-30",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-373-7600"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0061RL",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2008; 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.