OrganizationPlano Primary Care Clinic PaInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address4101 W Spring Creek Pkwy, Suite 300, Plano, TX 75024-5307(972) 398-8161PECOS EnrollmentBased on the most recent information from CMS, provider Plano Primary Care Clinic Pa does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1528249992Provider TypeOrganizationFull NamePlano Primary Care Clinic PaSubpartNoEnumeration Date11/14/2007Last Updated11/14/2013Contact InformationPractice LocationPractice Address4101 W Spring Creek Pkwy, Suite 300, Plano, TX 75024-5307Phone(972) 398-8161Fax(972) 398-8121Mailing LocationMailing Address4101 W Spring Creek Pkwy, Suite 300, Plano, TX 75024-5307Phone(972) 398-8161Fax(972) 398-8121Authorized OfficialNameFarooqi, Muhammad Moin (Medical Doctor)Phone(972) 398-8161Provider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseK4055TexasProvider IdentifiersIDDescriptionIssuerID00675NDescriptionOtherIssuerMEDICARETexasID0028EEDescriptionOtherIssuerBLUE CROSS BLUE SHIELDTexasID080985701DescriptionMedicaidIssuerUnlistedTexas