Provider Demographics
NPI:1952061194
Name:TWIN CITY MEDICAL
Entity Type:Organization
Organization Name:TWIN CITY MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CAPEHEART
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:903-223-5931
Mailing Address - Street 1:5483 SUMMERHILL RD
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-4608
Mailing Address - Country:US
Mailing Address - Phone:903-223-5931
Mailing Address - Fax:903-223-5930
Practice Address - Street 1:5483 SUMMERHILL RD
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-4608
Practice Address - Country:US
Practice Address - Phone:903-223-5931
Practice Address - Fax:903-223-5930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-29
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care