Provider Demographics
NPI:1942768668
Name:PRIMARY INTENTION PLLC
Entity Type:Organization
Organization Name:PRIMARY INTENTION PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PA-C
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:G
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:386-547-0975
Mailing Address - Street 1:728 JOHNS WELL CT
Mailing Address - Street 2:
Mailing Address - City:ARGYLE
Mailing Address - State:TX
Mailing Address - Zip Code:76226-1729
Mailing Address - Country:US
Mailing Address - Phone:386-547-0975
Mailing Address - Fax:
Practice Address - Street 1:728 JOHNS WELL CT
Practice Address - Street 2:
Practice Address - City:ARGYLE
Practice Address - State:TX
Practice Address - Zip Code:76226-1729
Practice Address - Country:US
Practice Address - Phone:386-547-0975
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-12
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty