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General NPI Number Information
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NPI Number | 1538928726
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Entity Type | Organization
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Legal Business Name | SPIRIT CARE OF TEXAS PC
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Dates
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Enumeration Date | 03/18/2024
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Last Update Date | 03/18/2024
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Provider Practice Location Address
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Address Line | 6504 NANCY ELLEN ST
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City | AMARILLO
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State | TX
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Zip | 79119-6327
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Country | US
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Telephone | 877-418-2466
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Fax | 877-460-4201
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Provider Business Mailing Address
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Address Line | 3725 HAMILTON MILL RD
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City | BUFORD
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State | GA
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Zip | 30519-3909
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Country | US
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Telephone | 877-418-2466
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Fax | 877-460-4201
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Authorized Official
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Title or Position | OWNER
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Name | ARVIND CHAKRAVARTHY
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Credential |
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Telephone | 810-814-0963
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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