Healthcare Provider Details
I. General information
NPI: 1083173652
Provider Name (Legal Business Name): PRIME CARE HEALTH SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/13/2019
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
912 WRIGHT ST STE A
ARLINGTON TX
76012-4759
US
IV. Provider business mailing address
13601 PRESTON RD STE 520
DALLAS TX
75240-4911
US
V. Phone/Fax
- Phone: 214-613-2019
- Fax: 214-617-0267
- Phone: 214-613-2019
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM1300X |
| Taxonomy | Multi-Specialty Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 133NN1002X |
| Taxonomy | Nutrition Education Nutritionist |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2083P0901X |
| Taxonomy | Public Health & General Preventive Medicine Physician |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 174H00000X |
| Taxonomy | Health Educator |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QH0100X |
| Taxonomy | Health Service Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JOY
E
AGUWA
Title or Position: MANAGING MEMBER
Credential: PHARMD.
Phone: 817-897-7460