Provider Demographics
NPI:1427397314
Name:FAUSTUS LENAMOND EMERGENT CARE, PA
Entity Type:Organization
Organization Name:FAUSTUS LENAMOND EMERGENT CARE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LENAMOND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-713-7124
Mailing Address - Street 1:PO BOX 173776
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76003-3776
Mailing Address - Country:US
Mailing Address - Phone:817-713-7124
Mailing Address - Fax:
Practice Address - Street 1:2228 WALNUT MANOR DR
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-5856
Practice Address - Country:US
Practice Address - Phone:817-713-7124
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-12
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty