Provider Demographics
NPI:1174913842
Name:MD NOW
Entity type:Organization
Organization Name:MD NOW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:D
Authorized Official - Last Name:DEMARQUE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-308-8477
Mailing Address - Street 1:4020 N MACARTHUR BLVD
Mailing Address - Street 2:#122-286
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-6419
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:509 N HAMPTON RD
Practice Address - Street 2:SUITE C
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-4970
Practice Address - Country:US
Practice Address - Phone:469-297-6575
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-02
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center