Healthcare Provider Details

I. General information

NPI: 1164974143
Provider Name (Legal Business Name): FASCIAMEDICA PROMPTA, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2016
Last Update Date: 12/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

865 DESHONG DR
PARIS TX
75460-9313
US

IV. Provider business mailing address

5100 ELDORADO PKWY STE 102
MCKINNEY TX
75070-7295
US

V. Phone/Fax

Practice location:
  • Phone: 903-785-4521
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT CLIFTON RANKINS III
Title or Position: MANAGING PARTNER
Credential: M.D.
Phone: 469-714-4777