Provider Demographics
NPI:1295938686
Name:MINOR EMERGENCY OF PARIS, INC.
Entity type:Organization
Organization Name:MINOR EMERGENCY OF PARIS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:BLANKENAU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:940-382-9898
Mailing Address - Street 1:4400 TEASLEY LANE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-3403
Mailing Address - Country:US
Mailing Address - Phone:940-382-9898
Mailing Address - Fax:940-383-3815
Practice Address - Street 1:4400 TEASLEY LANE
Practice Address - Street 2:SUITE 200
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-3403
Practice Address - Country:US
Practice Address - Phone:940-382-9898
Practice Address - Fax:940-383-3815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-06
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ3744261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00T84UMedicare ID - Type Unspecified
TXE50406Medicare UPIN