Provider Demographics
NPI:1366908360
Name:APEX MEDICAL GROUP, PLLC
Entity type:Organization
Organization Name:APEX MEDICAL GROUP, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JADE
Authorized Official - Middle Name:
Authorized Official - Last Name:MALAY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:723-780-3839
Mailing Address - Street 1:290 S PRESTON RD STE 240
Mailing Address - Street 2:
Mailing Address - City:PROSPER
Mailing Address - State:TX
Mailing Address - Zip Code:75078-9835
Mailing Address - Country:US
Mailing Address - Phone:972-378-0383
Mailing Address - Fax:972-403-3434
Practice Address - Street 1:290 S PRESTON RD STE 240
Practice Address - Street 2:
Practice Address - City:PROSPER
Practice Address - State:TX
Practice Address - Zip Code:75078-9835
Practice Address - Country:US
Practice Address - Phone:972-378-0383
Practice Address - Fax:972-403-3434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-14
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty