Provider Demographics
NPI:1457394629
Name:PHC & ASSOCIATES, INC.
Entity type:Organization
Organization Name:PHC & ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:
Authorized Official - Last Name:O'ROURKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-265-7810
Mailing Address - Street 1:11601 PLANO RD STE 107
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-5244
Mailing Address - Country:US
Mailing Address - Phone:214-265-7810
Mailing Address - Fax:214-265-7817
Practice Address - Street 1:11601 PLANO RD STE 107
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-5244
Practice Address - Country:US
Practice Address - Phone:214-265-7810
Practice Address - Fax:214-265-7817
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-14
Last Update Date:2009-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0085720332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX016900501Medicaid
TX167157001Medicaid
TX0000531745OtherBLUE CROSS BLUE SHIELD
TX167157001Medicaid