Provider Demographics
NPI:1871100313
Name:YOUR CHOICE HEALTHCARE
Entity type:Organization
Organization Name:YOUR CHOICE HEALTHCARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CLINICAL OPERATIONS
Authorized Official - Prefix:MISS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:DEWIT
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:463-341-7800
Mailing Address - Street 1:1601 ELM ST STE 4210
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201-7282
Mailing Address - Country:US
Mailing Address - Phone:469-341-7800
Mailing Address - Fax:
Practice Address - Street 1:1111 N I 35 E
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-3509
Practice Address - Country:US
Practice Address - Phone:469-341-7800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-29
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty