Provider Demographics
NPI:1275935561
Name:EC POTRANCO, LLC
Entity Type:Organization
Organization Name:EC POTRANCO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:SEAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-784-1500
Mailing Address - Street 1:9255 DALLAS PKWY
Mailing Address - Street 2:110
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-4211
Mailing Address - Country:US
Mailing Address - Phone:281-784-1500
Mailing Address - Fax:281-209-8930
Practice Address - Street 1:9255 DALLAS PKWY
Practice Address - Street 2:110
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-4211
Practice Address - Country:US
Practice Address - Phone:281-784-1500
Practice Address - Fax:281-209-8930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-18
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX160133261QE0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXHH135EOtherBLUE CROSS BLUE SHIELD