Park Clinic Pa

LBN: Park Clinic Pa
Park Clinic Pa is an health care organization with primary practice located at 310 W Alameda , Iowa Park TX 76367-1600. The organization recently has only one registered license in Ambulatory Health Care Facilities / Clinic/Center, which is considered as the primary health care specialty. Park Clinic Pa can be contacted via phone (940) 592-4141, or through Avila, Fausto via phone (940) 592-4141.

Contact Information

Primary practice address
310 W Alameda Iowa Park TX 76367-1600
Phone: (940) 592-4141
Fax: (940) 592-4842
Website:
Map and Directions
Authorized official contact:
Name: Avila, Fausto Doctor of Medicine (MD)
Phone: (940) 592-4141

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X

Profile Details

NPI number 1538263702
LBN Legal business name Park Clinic Pa
DBA Doing business as
Authorized official Avila, Fausto Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Sep 11th, 2006
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538263702 NPPES
Texas MEDICAID 1115859

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