Provider Demographics
NPI:1982969515
Name:NORTH TEXAS PRIMARY CARE ASSOCIATES
Entity Type:Organization
Organization Name:NORTH TEXAS PRIMARY CARE ASSOCIATES
Other - Org Name:HEALTH E CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STUART
Authorized Official - Middle Name:C
Authorized Official - Last Name:PICKELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-732-8847
Mailing Address - Street 1:1701 RIVER RUN
Mailing Address - Street 2:SUITE 210
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76107-6579
Mailing Address - Country:US
Mailing Address - Phone:817-332-8847
Mailing Address - Fax:817-332-3614
Practice Address - Street 1:1701 RIVER RUN
Practice Address - Street 2:SUITE 210
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-6579
Practice Address - Country:US
Practice Address - Phone:817-332-8847
Practice Address - Fax:817-332-3614
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTH TEXAS SPECIALITY PHYSICIANS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-07-10
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care