Provider Demographics
NPI:1265323000
Name:DEVOTED PRIMARY CARE, LLC
Entity type:Organization
Organization Name:DEVOTED PRIMARY CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DARRELL
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLIOTT, NP
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:210-886-8020
Mailing Address - Street 1:1370 PANTHEON WAY STE 190
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-2296
Mailing Address - Country:US
Mailing Address - Phone:210-886-8020
Mailing Address - Fax:210-886-8021
Practice Address - Street 1:1370 PANTHEON WAY STE 190
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-2296
Practice Address - Country:US
Practice Address - Phone:210-886-8021
Practice Address - Fax:210-886-8021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-10
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service