GRAND PRAIRIE PROFESSIONAL GROUP, P. A.; NPI #1871850750

Contact Information

GRAND PRAIRIE PROFESSIONAL GROUP, P. A.

1171 107TH ST
GRAND PRAIRIE, TX 75050-2502

Phone: 615-727-8387
Fax: 615-457-8094
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Addiction Psychiatry	2084P0802X	86	Physician/Neuropsychiatry

Indicates primary specialty

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NPI Profile & details for GRAND PRAIRIE PROFESSIONAL GROUP, P. A.

NPI Number 1871850750

LBN Legal business name GRAND PRAIRIE PROFESSIONAL GROUP, P. A.

Authorized official MARK CALARCO - (FACILITY CEO)

Entity Organization

Organization subpart ¹ No

Enumeration date 04/18/2012

Last updated 08/25/2021 - About 5 years ago

Identifiers

License #

E1948

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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