Provider Demographics
NPI:1689128217
Name:PHYSICIAN ACUTE CARE SERVICES PLANO, PLLC
Entity Type:Organization
Organization Name:PHYSICIAN ACUTE CARE SERVICES PLANO, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHORT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:936-525-9216
Mailing Address - Street 1:PO BOX 190
Mailing Address - Street 2:
Mailing Address - City:NEW WAVERLY
Mailing Address - State:TX
Mailing Address - Zip Code:77358-0190
Mailing Address - Country:US
Mailing Address - Phone:936-525-9216
Mailing Address - Fax:713-808-9176
Practice Address - Street 1:2000 DALLAS PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-4312
Practice Address - Country:US
Practice Address - Phone:972-378-7878
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-11
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH000J1Z101OtherBLUE CROSS BLUE SHIELD