Healthcare Provider Details

I. General information

NPI: 1992035554
Provider Name (Legal Business Name): HOSPITAL CARE CONSULTANTS OF PARAGOULD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2010
Last Update Date: 04/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 W KINGSHIGHWAY
PARAGOULD AR
72450-5942
US

IV. Provider business mailing address

PO BOX 2458 MSC 500
SAN ANTONIO TX
78298-2458
US

V. Phone/Fax

Practice location:
  • Phone: 870-239-7000
  • Fax:
Mailing address:
  • Phone: 972-934-3200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: RON WEISS
Title or Position: CEO
Credential:
Phone: 972-934-3200