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General NPI Number Information
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NPI Number | 1265945463
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Entity Type | Organization
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Legal Business Name | A. A. PRIMARY CARE
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Dates
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Enumeration Date | 11/09/2017
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Last Update Date | 11/09/2017
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Provider Practice Location Address
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Address Line | 213 N KAUFMAN ST
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City | SEAGOVILLE
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State | TX
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Zip | 75159-3739
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Country | US
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Telephone | 469-333-5268
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Fax | 469-333-5288
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Provider Business Mailing Address
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Address Line | PO BOX 850064
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City | MESQUITE
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State | TX
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Zip | 75185-0064
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Country | US
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Telephone | 469-333-5268
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Fax | 469-333-5288
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ESMERALDA NAVARRO
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Credential |
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Telephone | 469-333-5268
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 018084
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License Number State | TX
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