Healthcare Provider Details

I. General information

NPI: 1487301685
Provider Name (Legal Business Name): CARRUS CARE PHYSICIANS GROUP INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2022
Last Update Date: 05/06/2024
Certification Date: 05/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 W 7TH AVE
BRISTOW OK
74010-2302
US

IV. Provider business mailing address

1810 W US HIGHWAY 82
SHERMAN TX
75092-7069
US

V. Phone/Fax

Practice location:
  • Phone: 918-807-5029
  • Fax:
Mailing address:
  • Phone: 903-870-2745
  • Fax: 903-870-2795

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. ANBU NACHIMUTHU
Title or Position: CHAIRMAN/CEO
Credential:
Phone: 903-870-2745