Healthcare Provider Details

I. General information

NPI: 1164289302
Provider Name (Legal Business Name): DIRECT CARE PARTNERS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2024
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3421 BUNNY RUN
AUSTIN TX
78746-1746
US

IV. Provider business mailing address

539 W COMMERCE ST # 1180
DALLAS TX
75208-1953
US

V. Phone/Fax

Practice location:
  • Phone: 888-271-4608
  • Fax:
Mailing address:
  • Phone: 888-271-4608
  • Fax: 800-662-1774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: KEVIN MARSHALL PEARCE
Title or Position: MANAGER
Credential:
Phone: 214-232-9870