MODOMA PHYSICAL MEDICINE (NPI# 1538564018) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538564018 |
| Entity Type | Organization |
| Organization Name | MODOMA PHYSICAL MEDICINE |
| Practice Address |
5301 Village Creek Dr Suite B Plano TX 75093-4838 |
| Mailing Address |
4020 N Macarthur Blvd #122-286 Irving TX 75038-6419 |
| Practice Telephone | 9722503443 |
| Enumeration Date | 2014-10-27 |
| Last Update Date | 2014-10-27 |
| Authorized Official Name | CHARLES DEMARQUE (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 8173088477 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Street Address |
5301 VILLAGE CREEK DR SUITE B |
| City | PLANO |
| State | TX |
| Zip Code | 75093-4838 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205905700 | Gail S Donoff | Social Worker | 5301 Village Creek Dr, Suite D, Plano, TX 75093-4838 | 2006-11-07 |
| 1669861597 | Balance Counseling Inc | Community/Behavioral Health | 5301 Village Creek Dr, Ste E, Plano, TX 75093-4838 | 2015-01-15 |
| 1639506223 | The Knead Medmassage LLC | Chiropractor | 5301 Village Creek Dr, Suite B, Plano, TX 75093-4838 | 2013-09-27 |
| 1134471535 | Brockman Counseling LLC | Counselor | 5301 Village Creek Dr, Ste B, Plano, TX 75093-4838 | 2012-10-09 |
| 1306147392 | Senior Personal Care LLC | Home Health | 5301 Village Creek Dr, Suite A, Plano, TX 75093-4838 | 2010-11-08 |
| 1790935062 | Consulting 4 Children On The Spectrum, LLC. | Community/Behavioral Health | 5301 Village Creek Dr, Suite C, Plano, TX 75093-4838 | 2008-09-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235789041 | Mapleshade Surgery Center, LLC | Clinic/Center | 960 Ohio Dr, Plano, TX 75093 | 2019-09-13 |
| 1003461468 | Psyclear, LLC | Psychologist | 5055 West Park Boulevard, Suite 400, Plano, TX 75093 | 2019-08-02 |
| 1962981795 | Ep Anesthesia Pllc | Anesthesiology | 4100 Mapleshade Ln, Plano, TX 75093 | 2018-08-13 |
| 1669973939 | Eva Walekhwa | Registered Nurse | 6000 Ohio Drive, Apt 1027, Plano, TX 75093 | 2018-02-22 |
| 1437657624 | Advanced Spine Center | Orthopaedic Surgery | 1705 Ohio Drive, Suite 300, Plano, TX 75093 | 2018-01-23 |
| 1184139974 | Erica Cherese Carey | Nurse Practitioner | 1100 Allied Drive, Plano, TX 75093 | 2017-12-04 |
| 1457865578 | Norma Vigilant | Specialist/Technologist, Other | 4909 West Park Blvd, Plaza Park Salons, Plano, TX 75093 | 2017-11-28 |
| 1891214011 | Americare Rx Pharmacy Inc | Pharmacy | 4010 W. 15th St., Ste 60, Plano, TX 75093 | 2017-09-19 |
| 1760912554 | Baylor Surgicare At Baylor Plano, LLC | Clinic/Center | 4825 Alliance, Sute 300, Plano, TX 75093 | 2017-06-14 |
| 1881133262 | Dr.seshagiri Rao | Preferred Provider Organization | 3016 Communications Pkwy, Ste 100, Plano, TX 75093 | 2017-02-17 |
| Find all providers in zip 75093 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801414321 | Crate of Papaya LLC | Clinic/Center | 6320 Woodway Ln, Plano, TX 75093-7903 | 2020-07-10 |
| 1194293795 | Rajani Rao Md Pllc | Clinic/Center | 2237 W Parker Rd Ste D, Plano, TX 75023-7800 | 2018-11-13 |
| 1437644036 | Hennen Chiropractic Neurology and Wellness | Clinic/Center | 4105 W Spring Creek Pkwy Ste 510, Plano, TX 75024-5294 | 2018-06-26 |
| 1497277420 | Resolute Specialty Imaging | Clinic/Center | 7711 San Jacinto Pl Ste 200, Plano, TX 75024-3296 | 2017-07-11 |
| 1073064218 | Eating Recovery Center of Texas | Clinic/Center | 4716 Alliance Blvd Ste 400, Plano, TX 75093-5303 | 2016-10-24 |
| 1306395884 | Ambulatory 22 | Clinic/Center | 5760 Legacy Dr, Suite B-325, Plano, TX 75024-7102 | 2016-09-26 |
| 1487100319 | Dallas County Hospital District D/b/a Parkland Health and Hospital Sys | Clinic/Center | 1900 Harrington Dr, Plano, TX 75075-2714 | 2016-08-31 |
| 1124400197 | Texas Premier Ob/gyn Center Pllc | Clinic/Center | 5934 W Parker Rd Ste 500, Plano, TX 75093-6429 | 2015-06-25 |
| 1962747634 | Hitesh Yagnik, Md Pa | Clinic/Center | 5930 W.parket Road, Suite 900, Plano, TX 75093 | 2012-12-06 |
| 1366787061 | Jeffrey Adelglass Md Pa | Clinic/Center | 6020 W Parker Rd Ste 400, Plano, TX 75093-8175 | 2012-12-06 |
| Find all providers in PLANO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.