Provider Demographics
NPI:1053624965
Name:AMCARE UNIVERSAL HEALTHCARE CLINIC, P.L.L.C.
Entity type:Organization
Organization Name:AMCARE UNIVERSAL HEALTHCARE CLINIC, P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SORAYA
Authorized Official - Middle Name:D
Authorized Official - Last Name:FLETCHER
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:940-387-5577
Mailing Address - Street 1:3327 COLORADO BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-6866
Mailing Address - Country:US
Mailing Address - Phone:940-387-5577
Mailing Address - Fax:940-380-1577
Practice Address - Street 1:3327 COLORADO BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-6866
Practice Address - Country:US
Practice Address - Phone:940-387-5577
Practice Address - Fax:940-380-1577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-20
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX638551363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty