Basic Information
| Provider Information | |||||||||
| NPI: | 1093144610 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ARLINGTON PHYSICIAN SERVICES PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 265 BROOKVIEW CENTRE WAY | ||||||||
| Address2: | STE 400 | ||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 379194049 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8656931000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11800 ASTORIA BLVD | ||||||||
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| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770896041 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9196551325 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/04/2013 | ||||||||
| LastUpdateDate: | 11/10/2015 | ||||||||
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| AuthorizedOfficialLastName: | KOULISIS | ||||||||
| AuthorizedOfficialFirstName: | CHRISTO | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8656931000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery | 208M00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Hospitalist | 207V00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.