Organization · NPI-2

Centerwell Senior Primary Care (Tx) PA

Internal Medicine · Port Arthur, TX

NPI number1568094282
StatusActive
Last updated in NPPESOct 18, 2022

Details

NPI
1568094282
Entity type
Organization (NPI-2)
Legal business name
Centerwell Senior Primary Care (Tx) PA
Organization subpart
Yes
Enumeration date
Feb 11, 2020
Certification date
Oct 18, 2022
Last updated
Oct 18, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal Medicine––Yes
207Q00000X Family Medicine––
208D00000X General Practice––

Other names

  • Partners In Primary Care Tx, PA (Former Legal Business Name)
  • Partners In Primary Care- Port Arthur (Former Legal Business Name)
  • Centerwell Senior Primary Care - Port Arthur (Doing Business As)
  • Partners In Primary Care Ks, PA (Former Legal Business Name)

Practice location

8555 Memorial Blvd Ste 100
Port Arthur, TX 77640-7001

Phone 409-237-6480 · Fax 833-749-0330

Mailing address

4700 Millenia Blvd Ste 650
Orlando, FL 32839-6013

Phone 407-447-7120 · Fax 407-770-0661

Authorized official

Angie Martinez
Senior Credentialing Professional
4074477120

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