Basic Information
Provider Information | |||||||||
NPI: | 1881917037 | ||||||||
EntityType: | 2 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: | COLLIN COUNTY ONCOLOGY ASSOCIATES, PA | ||||||||
LastName: |   | ||||||||
FirstName: |   | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: |   | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | PO BOX 941929 | ||||||||
Address2: |   | ||||||||
City: | PLANO | ||||||||
State: | TX | ||||||||
PostalCode: | 750941929 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9726391311 | ||||||||
FaxNumber: | 9723773156 | ||||||||
Practice Location | |||||||||
Address1: | 4101 W SPRING CREEK PKWY | ||||||||
Address2: | SUITE 300 | ||||||||
City: | PLANO | ||||||||
State: | TX | ||||||||
PostalCode: | 750245307 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 2145300983 | ||||||||
FaxNumber: | 9723773156 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 03/02/2010 | ||||||||
LastUpdateDate: | 03/02/2010 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: |   | ||||||||
AuthorizedOfficialLastName: | QURESHI | ||||||||
AuthorizedOfficialFirstName: | KHUSROO | ||||||||
AuthorizedOfficialMiddleName: | MOHAMMAD | ||||||||
AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
AuthorizedOfficialTelephone: | 9726391311 | ||||||||
IsSoleProprietor: |   | ||||||||
IsOrganizationSubpart: | N | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: | DR. | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: | M.D | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0003X | N0390 | TX | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
No ID Information.