Provider Demographics
NPI:1265945463
Name:A. A. PRIMARY CARE
Entity type:Organization
Organization Name:A. A. PRIMARY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ESMERALDA
Authorized Official - Middle Name:
Authorized Official - Last Name:NAVARRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-333-5268
Mailing Address - Street 1:PO BOX 850064
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75185-0064
Mailing Address - Country:US
Mailing Address - Phone:469-333-5268
Mailing Address - Fax:469-333-5288
Practice Address - Street 1:213 N KAUFMAN ST
Practice Address - Street 2:
Practice Address - City:SEAGOVILLE
Practice Address - State:TX
Practice Address - Zip Code:75159-3739
Practice Address - Country:US
Practice Address - Phone:469-333-5268
Practice Address - Fax:469-333-5288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-09
Last Update Date:2017-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX018084253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care