=====================================================
General NPI Number Information
=====================================================
NPI Number | 1457514648
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PRMC HEALTHCARE GROUP INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/08/2008
-----------------------------------------------------
Last Update Date | 11/10/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 865 DESHONG DR
-----------------------------------------------------
City | PARIS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75460-9313
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 903-739-7461
-----------------------------------------------------
Fax | 903-739-7935
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 865 DESHONG DR
-----------------------------------------------------
City | PARIS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75460-9313
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 903-739-7461
-----------------------------------------------------
Fax | 903-739-7935
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SECRETARY
-----------------------------------------------------
Name | CHARLOTTE LAWRENCE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 615-920-7000
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 2084N0400X
-----------------------------------------------------
Taxonomy Name | Neurology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 208600000X
-----------------------------------------------------
Taxonomy Name | Surgery Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #5
-----------------------------------------------------
Taxonomy Code | 208D00000X
-----------------------------------------------------
Taxonomy Name | General Practice Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------