Provider Demographics
NPI:1598921256
Name:MID-LEVEL CARE, LLC
Entity Type:Organization
Organization Name:MID-LEVEL CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:POMALES
Authorized Official - Suffix:JR
Authorized Official - Credentials:MHS, PA-C
Authorized Official - Phone:469-441-6845
Mailing Address - Street 1:2550 CROSS TIMBERS RD
Mailing Address - Street 2:SUITE 116, MAILBOX 204
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-2621
Mailing Address - Country:US
Mailing Address - Phone:469-441-6845
Mailing Address - Fax:877-801-2318
Practice Address - Street 1:2550 CROSS TIMBERS RD
Practice Address - Street 2:SUITE 116, MAILBOX 204
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-2621
Practice Address - Country:US
Practice Address - Phone:469-441-6845
Practice Address - Fax:877-801-2318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-01
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA 02974363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty