Provider Demographics
NPI:1619698651
Name:PRIMARY CARE OF TEXAS PLLC
Entity Type:Organization
Organization Name:PRIMARY CARE OF TEXAS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND PROVIDER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:AGUILAR
Authorized Official - Last Name:DAVILA
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:210-473-7815
Mailing Address - Street 1:1712 CHARDONNAY
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78132-1885
Mailing Address - Country:US
Mailing Address - Phone:210-473-7815
Mailing Address - Fax:
Practice Address - Street 1:1712 CHARDONNAY
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78132-1885
Practice Address - Country:US
Practice Address - Phone:210-473-7815
Practice Address - Fax:833-464-2984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-08
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center