Healthcare Provider Details

I. General information

NPI: 1295414720
Provider Name (Legal Business Name): PRIMASUN MEDICAL GROUP OF TEXAS, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2023
Last Update Date: 07/12/2023
Certification Date: 07/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8300 HEALTH PARK STE 201
RALEIGH NC
27615-4731
US

IV. Provider business mailing address

8300 HEALTH PARK STE 201
RALEIGH NC
27615-4731
US

V. Phone/Fax

Practice location:
  • Phone: 919-230-2569
  • Fax:
Mailing address:
  • Phone: 919-230-2569
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS1201X
TaxonomySleep Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: JAMILA BATTLE
Title or Position: PRESIDENT
Credential: MD
Phone: 919-230-2569