=====================================================
General NPI Number Information
=====================================================
NPI Number | 1679037337
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CATES CARE PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/28/2019
-----------------------------------------------------
Last Update Date | 01/29/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 501 W 1ST ST
-----------------------------------------------------
City | BORGER
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79007-4066
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 806-626-3496
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 14310 FM 2186
-----------------------------------------------------
City | AMARILLO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79119-6621
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 806-626-3496
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PROVIDER/OWNER
-----------------------------------------------------
Name | DEAN CATES
-----------------------------------------------------
Credential | FNP-C
-----------------------------------------------------
Telephone | 806-626-3496
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------