Provider Demographics
NPI:1558641472
Name:A BRIGHTER CHOICE
Entity Type:Organization
Organization Name:A BRIGHTER CHOICE
Other - Org Name:BRIAN ARCENEAUX/EDWINA SMITH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:EDWINA
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:682-472-4680
Mailing Address - Street 1:PO BOX 14167
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76094-1167
Mailing Address - Country:US
Mailing Address - Phone:214-707-9387
Mailing Address - Fax:
Practice Address - Street 1:1309 PORTA ST APT 805
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76120-4109
Practice Address - Country:US
Practice Address - Phone:214-707-9387
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-23
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization