Provider Demographics
NPI: | 1174298350 |
---|---|
Name: | ACCURA HEALTH II LLC |
Entity Type: | Organization |
Organization Name: | ACCURA HEALTH II LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | DIRECTOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | MUFADDAL |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | BOOTWALA |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 972-559-4150 |
Mailing Address - Street 1: | PO BOX 852771 |
Mailing Address - Street 2: | |
Mailing Address - City: | RICHARDSON |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 75085-2771 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1222 E ARAPAHO RD STE 305 |
Practice Address - Street 2: | |
Practice Address - City: | RICHARDSON |
Practice Address - State: | TX |
Practice Address - Zip Code: | 75081-2402 |
Practice Address - Country: | US |
Practice Address - Phone: | 972-559-4150 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2021-08-10 |
Last Update Date: | 2022-10-11 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
No | 163WW0000X | Nursing Service Providers | Registered Nurse | Wound Care | Group - Multi-Specialty |
No | 207P00000X | Allopathic & Osteopathic Physicians | Emergency Medicine | Group - Multi-Specialty | |
No | 207QA0505X | Allopathic & Osteopathic Physicians | Family Medicine | Adult Medicine | Group - Multi-Specialty |
No | 207QH0002X | Allopathic & Osteopathic Physicians | Family Medicine | Hospice and Palliative Medicine | Group - Multi-Specialty |
No | 207RG0300X | Allopathic & Osteopathic Physicians | Internal Medicine | Geriatric Medicine | Group - Multi-Specialty |
No | 207RH0003X | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | Group - Multi-Specialty |
No | 2081H0002X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Hospice and Palliative Medicine | Group - Multi-Specialty |
No | 2279P3800X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | Palliative/Hospice | Group - Multi-Specialty |
No | 261QU0200X | Ambulatory Health Care Facilities | Clinic/Center | Urgent Care | Group - Multi-Specialty |
No | 363LA2200X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health | Group - Multi-Specialty |
No | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | Group - Multi-Specialty |
No | 251F00000X | Agencies | Home Infusion | Group - Multi-Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
OTHER | Other | OTHER |