Healthcare Provider Details

I. General information

NPI: 1659651701
Provider Name (Legal Business Name): AVERE HEALTHCARE CLINICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2011
Last Update Date: 06/26/2024
Certification Date: 06/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2535 CHARLOTTE ST SUITE 102
DENTON TX
76201-3301
US

IV. Provider business mailing address

2535 CHARLOTTE ST SUITE 102
DENTON TX
76201-3301
US

V. Phone/Fax

Practice location:
  • Phone: 940-387-7300
  • Fax: 940-387-1848
Mailing address:
  • Phone: 940-387-7300
  • Fax: 940-387-1848

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CAROL HEDTKE
Title or Position: MANAGING MEMBER
Credential: NP
Phone: 817-891-8356