Healthcare Provider Details

I. General information

NPI: 1144884792
Provider Name (Legal Business Name): PCCA TEXAS INTENSIVISTS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2019
Last Update Date: 06/20/2025
Certification Date: 06/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 PINE ST
ABILENE TX
79601-2432
US

IV. Provider business mailing address

PO BOX 641057
PITTSBURGH PA
15264-1057
US

V. Phone/Fax

Practice location:
  • Phone: 412-822-7410
  • Fax: 412-822-7411
Mailing address:
  • Phone: 412-822-7410
  • Fax: 412-822-7411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID A GREEN
Title or Position: OWNER
Credential: MD
Phone: 412-822-7410