Provider Demographics
NPI:1508307679
Name:ACTION FAMILY CARE PLLC
Entity Type:Organization
Organization Name:ACTION FAMILY CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:MR
Authorized Official - First Name:HOSS
Authorized Official - Middle Name:
Authorized Official - Last Name:MANSOORI
Authorized Official - Suffix:
Authorized Official - Credentials:ANP
Authorized Official - Phone:214-553-5543
Mailing Address - Street 1:11615 FOREST CENTRAL DR
Mailing Address - Street 2:214
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75024-3910
Mailing Address - Country:US
Mailing Address - Phone:214-553-5543
Mailing Address - Fax:
Practice Address - Street 1:3100 INDEPENDENCE PKWY
Practice Address - Street 2:SUITE 103A
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-1964
Practice Address - Country:US
Practice Address - Phone:214-553-5543
Practice Address - Fax:214-553-5543
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-09
Last Update Date:2018-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP130793363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty