Healthcare Provider Details

I. General information

NPI: 1821799917
Provider Name (Legal Business Name): TRUCARE HEALTH CLINIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2023
Last Update Date: 03/15/2023
Certification Date: 03/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2675 41ST ST SE STE 102
PARIS TX
75462-8209
US

IV. Provider business mailing address

2675 41ST ST SE STE 102
PARIS TX
75462-8209
US

V. Phone/Fax

Practice location:
  • Phone: 903-739-7700
  • Fax: 903-739-7989
Mailing address:
  • Phone: 903-609-1065
  • Fax: 903-739-7989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MISHAYLA BREWER
Title or Position: PRACTICE MANAGER
Credential:
Phone: 903-609-1065