=====================================================
General NPI Number Information
=====================================================
NPI Number | 1265063986
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ASSURED PRIMARY CARE GROUP, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/31/2020
-----------------------------------------------------
Last Update Date | 01/12/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1016 COTTON PATCH TRL
-----------------------------------------------------
City | LEANDER
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78641-3238
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-298-9095
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 682781
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77268-2781
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-298-9095
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR OF OPERATIONS
-----------------------------------------------------
Name | BRANDY B CLARK
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 832-298-9098
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 385H00000X
-----------------------------------------------------
Taxonomy Name | Respite Care
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------