Provider Demographics
NPI:1548729098
Name:CONCIERGE MOBILE MD, PLLC
Entity type:Organization
Organization Name:CONCIERGE MOBILE MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:Y
Authorized Official - Last Name:TANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:682-223-1526
Mailing Address - Street 1:2549 SPRINGHILL DR
Mailing Address - Street 2:
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-7157
Mailing Address - Country:US
Mailing Address - Phone:682-223-1526
Mailing Address - Fax:817-488-6932
Practice Address - Street 1:2549 SPRINGHILL DR
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-7157
Practice Address - Country:US
Practice Address - Phone:682-223-1526
Practice Address - Fax:817-488-6932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-14
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty