Provider Demographics
NPI:1821799917
Name:TRUCARE HEALTH CLINIC, LLC
Entity Type:Organization
Organization Name:TRUCARE HEALTH CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MISHAYLA
Authorized Official - Middle Name:
Authorized Official - Last Name:BREWER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-609-1065
Mailing Address - Street 1:2675 41ST ST SE STE 102
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75462-8209
Mailing Address - Country:US
Mailing Address - Phone:903-609-1065
Mailing Address - Fax:903-739-7989
Practice Address - Street 1:2675 41ST ST SE STE 102
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75462-8209
Practice Address - Country:US
Practice Address - Phone:903-739-7700
Practice Address - Fax:903-739-7989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-15
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care