Purple Hearts Primary Care Services

LBN: Purple Hearts Primary Care Services, Pllc
Purple Hearts Primary Care Services is an health care organization with primary practice located at 688 W Pioneer Pkwy Ste 120 , Grand Prairie TX 75051-4861. The organization recently has only one registered license in Ambulatory Health Care Facilities / Primary Care, which is considered as the primary health care specialty. Purple Hearts Primary Care Services, Pllc can be contacted via phone (817) 969-4651, or through Modisette, Raven via phone (817) 969-4651.

Contact Information

Primary practice address
688 W Pioneer Pkwy Ste 120 Grand Prairie TX 75051-4861
Phone: (817) 969-4651
Fax: (214) 710-2188
Website:
Map and Directions
Authorized official contact:
Name: Modisette, Raven FNP-C,PMHNP-BC
Phone: (817) 969-4651

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Primary Care 261QP2300X AP137299 Texas

Profile Details

NPI number 1043703358
LBN Legal business name Purple Hearts Primary Care Services, Pllc
DBA Doing business as Purple Hearts Primary Care Services
Authorized official Modisette, Raven FNP-C,PMHNP-BC
Entity Organization
Organization subpart 1 No
Enumeration date Jun 11th, 2018
Last updated Dec 7th, 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 1043703358 NPPES
Texas MEDICAID 393575101

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