Provider Demographics
NPI:1568187235
Name:GRAND PRAIRIE URGENT CARE PLLC
Entity Type:Organization
Organization Name:GRAND PRAIRIE URGENT CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SIREESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:JANGA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-755-1758
Mailing Address - Street 1:5204 S HWY 360 STE 400
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-0947
Mailing Address - Country:US
Mailing Address - Phone:972-971-7945
Mailing Address - Fax:972-602-4522
Practice Address - Street 1:5204 S HWY 360 STE 400
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-0947
Practice Address - Country:US
Practice Address - Phone:972-755-1785
Practice Address - Fax:972-602-4522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-05
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care