Healthcare Provider Details

I. General information

NPI: 1962580118
Provider Name (Legal Business Name): TRI-CITY EXPRESS CARE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 05/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 E WILLIAMS FIELD RD SUITE 101
GILBERT AZ
85295-4880
US

IV. Provider business mailing address

890 W ELLIOT RD SUITE 103
GILBERT AZ
85233-5102
US

V. Phone/Fax

Practice location:
  • Phone: 480-855-9400
  • Fax: 480-782-1598
Mailing address:
  • Phone: 480-545-1413
  • Fax: 480-545-1434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License NumberOTC3513
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOTC3513
License Number StateAZ

VIII. Authorized Official

Name: DR. MICHAEL PATRICK DUNN
Title or Position: MEDICAL DIRECTOR/OWNER
Credential: M.D.
Phone: 480-545-1413