Basic Information
| Provider Information | |||||||||
| NPI: | 1255640678 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ELITE PATIENT CARE,PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3901A SPICEWOOD SPRINGS RD STE 201 | ||||||||
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| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787598728 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7372662700 | ||||||||
| FaxNumber: | 8886983908 | ||||||||
| Practice Location | |||||||||
| Address1: | 401 N MORGAN ST | ||||||||
| Address2: | |||||||||
| City: | SHELBY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 281504434 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7372266700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/04/2010 | ||||||||
| LastUpdateDate: | 12/10/2021 | ||||||||
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| AuthorizedOfficialLastName: | FRYE | ||||||||
| AuthorizedOfficialFirstName: | DALLAS | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 7372266700 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 12/10/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | TX | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 207R00000X | TX | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.