Provider Demographics
NPI:1477388866
Name:PRIMARY HOUSECALLS
Entity type:Organization
Organization Name:PRIMARY HOUSECALLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/NP
Authorized Official - Prefix:
Authorized Official - First Name:DEANNA
Authorized Official - Middle Name:ANNETTE
Authorized Official - Last Name:SHELTON
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:903-440-5544
Mailing Address - Street 1:334 COUNTY ROAD 1995
Mailing Address - Street 2:
Mailing Address - City:YANTIS
Mailing Address - State:TX
Mailing Address - Zip Code:75497-5447
Mailing Address - Country:US
Mailing Address - Phone:903-440-5544
Mailing Address - Fax:903-741-8434
Practice Address - Street 1:334 COUNTY ROAD 1995
Practice Address - Street 2:
Practice Address - City:YANTIS
Practice Address - State:TX
Practice Address - Zip Code:75497-5447
Practice Address - Country:US
Practice Address - Phone:903-440-5544
Practice Address - Fax:903-741-8434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-04
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty