Provider Demographics
NPI:1023010386
Name:ARLINGTON PREMIER HEALTH CLINIC PA
Entity type:Organization
Organization Name:ARLINGTON PREMIER HEALTH CLINIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:LIZ
Authorized Official - Middle Name:A
Authorized Official - Last Name:ALANIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-465-4141
Mailing Address - Street 1:501 RITA LN
Mailing Address - Street 2:STE 109
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76014-2010
Mailing Address - Country:US
Mailing Address - Phone:817-465-4141
Mailing Address - Fax:817-465-9714
Practice Address - Street 1:501 RITA LN
Practice Address - Street 2:STE 109
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-2010
Practice Address - Country:US
Practice Address - Phone:817-465-4141
Practice Address - Fax:817-465-9714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-01
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ7772207Q00000X
TXK5368207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX110176762OtherRR MEDICARE T DAO
TX5787151OtherCIGNA PROV T DAO
TX84540SOtherBCBS PROV NUMBER T DAO
TX1848499OtherUHC PROVIDER # T DAO
TX91145876OtherWAUSAU PROV # T DAO
TXJ7772OtherUNICARE DR MICHAEL V DAO
TX2079885OtherAETNA PROVIDER #
TX132930100OtherNPPN2 DR MICHAEL V DAO
TX0059554OtherPACIFICARE PPO T DAO
TX84541SOtherBCBS PROV # M DAO
TX5907540OtherCIGNA DR MICHAEL V DAO
TX91145876OtherWAUSAU DR MICHAEL V DAO
TXK5368OtherUNICARE PROV # T DAO
TXJ7772OtherUNICARE DR MICHAEL V DAO
TXK5368OtherUNICARE PROV # T DAO
TX0059554OtherPACIFICARE PPO T DAO
TX5787151OtherCIGNA PROV T DAO
TXG51896Medicare UPIN
TX84540SOtherBCBS PROV NUMBER T DAO