Basic Information
| Provider Information | |||||||||
| NPI: | 1740856970 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DISPATCHHEALTH ADVANCED CARE LLC | ||||||||
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| OtherOrganizationName: | DISPATCHHEALTH ADVANCED CARE HOUSTON | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3827 N LAFAYETTE ST | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802053339 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3035001815 | ||||||||
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| Practice Location | |||||||||
| Address1: | 211 HIGHLAND CROSS DR STE 105 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770731700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7134222920 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/28/2021 | ||||||||
| LastUpdateDate: | 09/12/2022 | ||||||||
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| AuthorizedOfficialLastName: | KNEELAND | ||||||||
| AuthorizedOfficialFirstName: | PATRICK | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 3034937245 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | DISPATCHHEALTH-TEXAS P A | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 09/12/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.