Provider Demographics
NPI:1376711457
Name:PRIMA HEALTH CLINIC, P.A.
Entity Type:Organization
Organization Name:PRIMA HEALTH CLINIC, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LINH
Authorized Official - Middle Name:B
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-276-8688
Mailing Address - Street 1:3555 W WALNUT ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042-4017
Mailing Address - Country:US
Mailing Address - Phone:972-276-8688
Mailing Address - Fax:972-276-4473
Practice Address - Street 1:3555 W WALNUT ST
Practice Address - Street 2:SUITE A
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-4017
Practice Address - Country:US
Practice Address - Phone:972-276-8688
Practice Address - Fax:972-276-4473
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-12
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QP2300X
TX149213332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies