Provider Demographics
NPI:1003209008
Name:MY CARE PLLC
Entity Type:Organization
Organization Name:MY CARE PLLC
Other - Org Name:MY CARE FAMILY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HEALTH CARE PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:LIZY
Authorized Official - Middle Name:JIMMY
Authorized Official - Last Name:JOHNS
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:469-573-9433
Mailing Address - Street 1:1112 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-6131
Mailing Address - Country:US
Mailing Address - Phone:469-573-9433
Mailing Address - Fax:
Practice Address - Street 1:1112 MAIN ST
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-6131
Practice Address - Country:US
Practice Address - Phone:469-573-9433
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-15
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service