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General NPI Number Information
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NPI Number | 1568187235
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Entity Type | Organization
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Legal Business Name | GRAND PRAIRIE URGENT CARE PLLC
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Dates
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Enumeration Date | 10/05/2022
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Last Update Date | 10/05/2022
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Provider Practice Location Address
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Address Line | 5204 S HWY 360 STE 400
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City | GRAND PRAIRIE
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State | TX
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Zip | 75052-0947
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Country | US
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Telephone | 972-755-1785
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Fax | 972-602-4522
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Provider Business Mailing Address
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Address Line | 5204 S HWY 360 STE 400
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City | GRAND PRAIRIE
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State | TX
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Zip | 75052-0947
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Country | US
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Telephone | 972-971-7945
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Fax | 972-602-4522
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. SIREESHA JANGA
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Credential | MD
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Telephone | 972-755-1758
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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