Provider Demographics
NPI:1336681170
Name:DYNAMIC RPA HEALTHCARE PA
Entity Type:Organization
Organization Name:DYNAMIC RPA HEALTHCARE PA
Other - Org Name:DYNAMIC RPA PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:A
Authorized Official - Last Name:INEAMA
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:817-294-9600
Mailing Address - Street 1:3750 S UNIVERSITY DR STE 275
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76109-3795
Mailing Address - Country:US
Mailing Address - Phone:817-294-9600
Mailing Address - Fax:817-294-9611
Practice Address - Street 1:3750 S UNIVERSITY DR STE 275
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76109-3795
Practice Address - Country:US
Practice Address - Phone:817-294-9600
Practice Address - Fax:817-294-9611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty