Provider Demographics
NPI:1770151128
Name:DIRECT PRIMED CARE PLLC
Entity type:Organization
Organization Name:DIRECT PRIMED CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ABDIER
Authorized Official - Middle Name:
Authorized Official - Last Name:DELGADO GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-380-7831
Mailing Address - Street 1:180 STATE ST STE 225
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-7632
Mailing Address - Country:US
Mailing Address - Phone:817-497-8328
Mailing Address - Fax:817-837-0832
Practice Address - Street 1:180 STATE ST STE 225
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-7632
Practice Address - Country:US
Practice Address - Phone:817-497-8328
Practice Address - Fax:817-837-0832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-14
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty