Provider Demographics
NPI:1861826893
Name:AUHB PRIMARY CARE PA
Entity Type:Organization
Organization Name:AUHB PRIMARY CARE PA
Other - Org Name:AUHB PRIMARY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ASIM
Authorized Official - Middle Name:RASHID
Authorized Official - Last Name:USMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:903-261-3303
Mailing Address - Street 1:4001 TECHNOLOGY CTR STE 302
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75605-2751
Mailing Address - Country:US
Mailing Address - Phone:903-261-3303
Mailing Address - Fax:903-663-1235
Practice Address - Street 1:3505 S BUCKNER BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75227-5451
Practice Address - Country:US
Practice Address - Phone:214-237-3250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-27
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty