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General NPI Number Information
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NPI Number | 1568130268
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Entity Type | Organization
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Legal Business Name | PROCARE EMERGENCY ROOM LLC
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Dates
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Enumeration Date | 08/30/2021
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Last Update Date | 08/30/2021
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Provider Practice Location Address
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Address Line | 3607 OAK LAWN AVE STE 100
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City | DALLAS
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State | TX
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Zip | 75219-4786
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Country | US
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Telephone | 469-750-1028
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Fax |
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Provider Business Mailing Address
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Address Line | 101 W RENNER RD STE 140
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City | RICHARDSON
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State | TX
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Zip | 75082-2028
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Country | US
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Telephone | 469-436-8100
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. FAWAD SARWAR
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Credential |
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Telephone | 708-415-4105
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0002X
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Taxonomy Name | Emergency Care Clinic/Center
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License Number |
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License Number State |
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