Provider Demographics
NPI:1477260065
Name:FPACP MIDLOTHIAN LLC
Entity Type:Organization
Organization Name:FPACP MIDLOTHIAN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARALEGAL
Authorized Official - Prefix:MS
Authorized Official - First Name:EVA
Authorized Official - Middle Name:M
Authorized Official - Last Name:ZAMORA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-379-0399
Mailing Address - Street 1:1401 BALLINGER ST
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76102-5905
Mailing Address - Country:US
Mailing Address - Phone:801-632-1000
Mailing Address - Fax:817-632-1001
Practice Address - Street 1:110 DYLAN WAY
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:TX
Practice Address - Zip Code:76065
Practice Address - Country:US
Practice Address - Phone:817-632-1000
Practice Address - Fax:817-632-1001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-02
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility