1215457726 NPI number — EXPECARE, LP

Table of content: MS. KAREN DIMAANO GARELLO OTRL (NPI 1386856714)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215457726 NPI number — EXPECARE, LP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EXPECARE, LP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1215457726
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/26/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6407 S COOPER ST STE 117
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ARLINGTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76001-5813
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
817-472-7601
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3909 W PARKER RD STE 104
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLANO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75023-6161
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
469-609-3062
Provider Business Practice Location Address Fax Number:
972-867-9400
Provider Enumeration Date:
06/26/2017

Additional Information

Authorized Official

Authorized Official Last Name:
SAEED
Authorized Official First Name:
UMAR
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
832-477-5164

Provider Taxonomy Codes

  • Taxonomy code: 261QU0200X , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0027XM . This is a "BCBS OF TX GROUP NUMBER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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