Healthcare Provider Details

I. General information

NPI: 1942040407
Provider Name (Legal Business Name): PRECISION HEALTH CLINIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2024
Last Update Date: 05/30/2024
Certification Date: 05/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9901 VALLEY RANCH PKWY E STE 1015
IRVING TX
75063-4777
US

IV. Provider business mailing address

5521 BELLAIRE DR S STE 200
FORT WORTH TX
76109-5855
US

V. Phone/Fax

Practice location:
  • Phone: 972-417-1936
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARIA ALCANTAR
Title or Position: MANAGER
Credential:
Phone: 817-412-0792