Provider Demographics
NPI:1841793312
Name:HRA IQ-TX LLC
Entity Type:Organization
Organization Name:HRA IQ-TX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:CINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-554-3329
Mailing Address - Street 1:4220 JOHN CT
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-1144
Mailing Address - Country:US
Mailing Address - Phone:214-554-3329
Mailing Address - Fax:
Practice Address - Street 1:4220 JOHN CT
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-1144
Practice Address - Country:US
Practice Address - Phone:214-554-3329
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-12
Last Update Date:2018-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Single Specialty