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PARK CLINIC PA NPI 1538263702


NPI Information

NPI: 1538263702
Provider Name: PARK CLINIC PA
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
310 W ALAMEDA
IOWA PARK, TX
ZIP 76367
Phone: (940) 592-4141
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PARK CLINIC PA is a clinic center in Iowa Park, TX. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). PARK CLINIC PA NPI is 1538263702. The provider is registered as an organization entity type.

The provider's business location address is:

310 W ALAMEDA
IOWA PARK, TX
ZIP 76367-600
Phone: (940) 592-4141
Fax: (940) 592-4842

The provider's authorized official is Fausto Avila .
The authorized official title is Sect Treasure and has the following contact phone number (940) 592-4141.

The enumeration date for this NPI number is 9/11/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261Q00000XClinic/CenterYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11115859MEDICAIDTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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