Healthcare Provider Details

I. General information

NPI: 1265147821
Provider Name (Legal Business Name): TTX PRIMARY CARE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2023
Last Update Date: 01/18/2023
Certification Date: 01/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2004 OLD GRANGER
TAYLOR TX
76574-3568
US

IV. Provider business mailing address

2004 OLD GRANGER
TAYLOR TX
76574-3568
US

V. Phone/Fax

Practice location:
  • Phone: 512-856-5551
  • Fax: 512-615-5188
Mailing address:
  • Phone: 512-856-5551
  • Fax: 512-615-5188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: ALINE C ZERINGUE
Title or Position: OWNER
Credential: CNS
Phone: 512-452-2506