=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770962599
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | APN
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/26/2015
-----------------------------------------------------
Last Update Date | 07/09/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 800 W ARBROOK BLVD STE 300
-----------------------------------------------------
City | ARLINGTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76015-4333
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-987-1172
-----------------------------------------------------
Fax | 817-549-2367
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 800 W ARBROOK BLVD STE 300
-----------------------------------------------------
City | ARLINGTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76015-4333
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-987-1172
-----------------------------------------------------
Fax | 817-549-2367
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | ALLAN BECK
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 817-583-7010
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM1300X
-----------------------------------------------------
Taxonomy Name | Multi-Specialty Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------