Provider Demographics
NPI:1114685708
Name:CAIT CARE PROVIDERS PLLC
Entity Type:Organization
Organization Name:CAIT CARE PROVIDERS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REPRESENTATIVE
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:CAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-650-1413
Mailing Address - Street 1:600 E ROSEDALE ST STE 125
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-5175
Mailing Address - Country:US
Mailing Address - Phone:682-207-3598
Mailing Address - Fax:
Practice Address - Street 1:600 E ROSEDALE ST STE 125
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-5175
Practice Address - Country:US
Practice Address - Phone:682-207-3598
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-01
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty