Basic Information
| Provider Information | |||||||||
| NPI: | 1538358239 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | AMERICAN CURRENT CARE PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5080 SPECTRUM DRIVE | ||||||||
| Address2: | 1200 WEST | ||||||||
| City: | ADDISON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750014625 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8002323550 | ||||||||
| FaxNumber: | 9723878058 | ||||||||
| Practice Location | |||||||||
| Address1: | 2209 NORTH PADRE ISLAND DRIVE | ||||||||
| Address2: | SUITE M | ||||||||
| City: | CORPUS CHRISTI | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78408 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3612891207 | ||||||||
| FaxNumber: | 3612891207 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/18/2007 | ||||||||
| LastUpdateDate: | 08/04/2010 | ||||||||
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| AuthorizedOfficialLastName: | FOGARTY | ||||||||
| AuthorizedOfficialFirstName: | TOM | ||||||||
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| AuthorizedOfficialTitleorPosition: | SENIOR VP/ CHIEF MEDICAL OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 9723648103 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261Q00000X | N | Ambulatory Health Care Facilities | Clinic/Center | 261QU0200X | Y | Ambulatory Health Care Facilities | Clinic/Center | Urgent Care |
No ID Information.