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1538564018
MODOMA PHYSICAL MEDICINE
PLANO, TX
NPI
1538564018
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Entity Type
Organization
Authorized Contact
CHARLES DEMARQUE
Medical Director
817-308-8477
Organization Subpart ?
No
Primary Taxonomy
261Q00000X Clinic/Center
Enumeration Date
2014-10-27
Last Update Date
2014-10-27
Business Address
MODOMA PHYSICAL MEDICINE
5301 VILLAGE CREEK DR SUITE B
PLANO, TX 75093-4838
Phone number: 972-250-3443
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Mailing Address
MODOMA PHYSICAL MEDICINE
4020 N MACARTHUR BLVD #122-286
IRVING, TX 75038-6419
Phone number:
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