Provider Demographics
NPI:1497428627
Name:PACIFIC ACCESS
Entity Type:Organization
Organization Name:PACIFIC ACCESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:HANNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-842-9516
Mailing Address - Street 1:4428 IRVIN SIMMONS DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75229-4247
Mailing Address - Country:US
Mailing Address - Phone:214-842-9516
Mailing Address - Fax:
Practice Address - Street 1:4428 IRVIN SIMMONS DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75229-4247
Practice Address - Country:US
Practice Address - Phone:214-842-9516
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-25
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies