Provider Demographics
NPI:1508051293
Name:ACT PHYSICIAN GROUP, P.A.
Entity Type:Organization
Organization Name:ACT PHYSICIAN GROUP, P.A.
Other - Org Name:CARE TODAY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:R
Authorized Official - Last Name:LACY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-379-9225
Mailing Address - Street 1:7118 I-40 W
Mailing Address - Street 2:SUITE 500
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-2503
Mailing Address - Country:US
Mailing Address - Phone:806-379-9225
Mailing Address - Fax:806-379-7661
Practice Address - Street 1:3300 I-40 E
Practice Address - Street 2:SUITE 400
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79103-4801
Practice Address - Country:US
Practice Address - Phone:806-379-9225
Practice Address - Fax:806-379-7661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-06
Last Update Date:2015-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care