Provider Demographics
NPI: | 1609852813 |
---|---|
Name: | AIDS ARMS, INC. |
Entity type: | Organization |
Organization Name: | AIDS ARMS, INC. |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | CEO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | JOHN |
Authorized Official - Middle Name: | THOMAS |
Authorized Official - Last Name: | CARLO |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 214-521-5191 |
Mailing Address - Street 1: | 3900 JUNIUS ST STE 300 |
Mailing Address - Street 2: | |
Mailing Address - City: | DALLAS |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 75246-1602 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 214-521-5191 |
Mailing Address - Fax: | 214-623-6806 |
Practice Address - Street 1: | 3900 JUNIUS ST STE 300 |
Practice Address - Street 2: | |
Practice Address - City: | DALLAS |
Practice Address - State: | TX |
Practice Address - Zip Code: | 75246-1602 |
Practice Address - Country: | US |
Practice Address - Phone: | 214-521-5191 |
Practice Address - Fax: | 214-623-6806 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2005-12-20 |
Last Update Date: | 2024-09-23 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
103TC1900X, 122300000X, 124Q00000X, 133V00000X, 163WC0400X, 1835P1200X, 207Q00000X, 207RI0200X, 2084P0800X, 251B00000X, 261QC1500X, 261QF0400X, 261QM0801X, 363LF0000X | ||
TX | 207R00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 261QF0400X | Ambulatory Health Care Facilities | Clinic/Center | Federally Qualified Health Center (FQHC) | |
No | 103TC1900X | Behavioral Health & Social Service Providers | Psychologist | Counseling | Group - Multi-Specialty |
No | 122300000X | Dental Providers | Dentist | Group - Multi-Specialty | |
No | 124Q00000X | Dental Providers | Dental Hygienist | Group - Multi-Specialty | |
No | 133V00000X | Dietary & Nutritional Service Providers | Dietitian, Registered | Group - Multi-Specialty | |
No | 163WC0400X | Nursing Service Providers | Registered Nurse | Case Management | Group - Multi-Specialty |
No | 1835P1200X | Pharmacy Service Providers | Pharmacist | Pharmacotherapy | Group - Multi-Specialty |
No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
No | 207RI0200X | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease | Group - Multi-Specialty |
No | 2084P0800X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | Group - Multi-Specialty |
No | 251B00000X | Agencies | Case Management | Group - Multi-Specialty | |
No | 261QC1500X | Ambulatory Health Care Facilities | Clinic/Center | Community Health | |
No | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) | Group - Multi-Specialty |
No | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | Group - Multi-Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
00156T | Medicare PIN |