Healthcare Provider Details
I. General information
NPI: 1679572242
Provider Name (Legal Business Name): ESSENT PRMC LP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/18/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
820 CLARKSVILLE ST
PARIS TX
75460-6027
US
IV. Provider business mailing address
PO BOX 9070
PARIS TX
75461-9070
US
V. Phone/Fax
- Phone: 903-737-3257
- Fax: 903-737-3375
- Phone: 903-737-3257
- Fax: 903-737-3375
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA1903X |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| License Number | |
| License Number State | TX |
VIII. Authorized Official
Name: MR.
MICHAEL
W
BROWDER
Title or Position: PRESIDENT & CEO
Credential:
Phone: 615-312-5103