Provider Demographics
NPI:1689442741
Name:PHCA LLC
Entity Type:Organization
Organization Name:PHCA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:TRENT
Authorized Official - Middle Name:AMBROSE
Authorized Official - Last Name:BARTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-395-9661
Mailing Address - Street 1:1325 BRENTFIELD DR
Mailing Address - Street 2:
Mailing Address - City:ANNA
Mailing Address - State:TX
Mailing Address - Zip Code:75409-4267
Mailing Address - Country:US
Mailing Address - Phone:703-395-9661
Mailing Address - Fax:
Practice Address - Street 1:1325 BRENTFIELD DR
Practice Address - Street 2:
Practice Address - City:ANNA
Practice Address - State:TX
Practice Address - Zip Code:75409-4267
Practice Address - Country:US
Practice Address - Phone:703-395-9661
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty