Provider Demographics
NPI:1164478343
Name:PROMPT CARE INTERNAL MEDICINE PA
Entity Type:Organization
Organization Name:PROMPT CARE INTERNAL MEDICINE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BASIL
Authorized Official - Middle Name:A
Authorized Official - Last Name:YOUNIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-620-8100
Mailing Address - Street 1:9 MEDICAL PKWY
Mailing Address - Street 2:SUITE 209
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-7858
Mailing Address - Country:US
Mailing Address - Phone:972-620-8100
Mailing Address - Fax:972-620-8106
Practice Address - Street 1:9 MEDICAL PKWY
Practice Address - Street 2:SUITE 209
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-7858
Practice Address - Country:US
Practice Address - Phone:972-620-8100
Practice Address - Fax:972-620-8106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK 9942261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX017624004Medicaid
TX00W982Medicare ID - Type UnspecifiedPROMPT CARE INTERNAL MEDI
TX017624004Medicaid
TXG01754Medicare UPIN