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General NPI Number Information
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NPI Number | 1265323000
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Entity Type | Organization
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Legal Business Name | DEVOTED PRIMARY CARE, LLC
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Dates
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Enumeration Date | 07/10/2025
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Last Update Date | 07/10/2025
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Provider Practice Location Address
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Address Line | 1370 PANTHEON WAY STE 190
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City | SAN ANTONIO
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State | TX
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Zip | 78232-2296
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Country | US
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Telephone | 210-886-8021
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Fax | 210-886-8021
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Provider Business Mailing Address
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Address Line | 1370 PANTHEON WAY STE 190
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City | SAN ANTONIO
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State | TX
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Zip | 78232-2296
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Country | US
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Telephone | 210-886-8020
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Fax | 210-886-8021
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Authorized Official
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Title or Position | OWNER
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Name | MR. DARRELL ELLIOTT, NP
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Credential | NP
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Telephone | 210-886-8020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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