Provider Demographics
NPI: | 1609184712 |
---|---|
Name: | 7 POINT MEDICAL CARE CENTER |
Entity type: | Organization |
Organization Name: | 7 POINT MEDICAL CARE CENTER |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | ADMINISTRATOR |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | EMMANUEL |
Authorized Official - Middle Name: | O |
Authorized Official - Last Name: | NWADEYI |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | PA-C |
Authorized Official - Phone: | 214-315-5255 |
Mailing Address - Street 1: | 6225 FALLBROOK DR |
Mailing Address - Street 2: | |
Mailing Address - City: | GARLAND |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 75043-5918 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 214-315-5255 |
Mailing Address - Fax: | 214-570-8293 |
Practice Address - Street 1: | 6225 FALLBROOK DR |
Practice Address - Street 2: | |
Practice Address - City: | GARLAND |
Practice Address - State: | TX |
Practice Address - Zip Code: | 75043-5918 |
Practice Address - Country: | US |
Practice Address - Phone: | 214-315-5255 |
Practice Address - Fax: | 214-570-8293 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2010-09-23 |
Last Update Date: | 2010-09-23 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
TX | PA04693 | 302R00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 302R00000X | Managed Care Organizations | Health Maintenance Organization |