Arca Medical Clinic, Inc.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

ARCA MEDICAL CLINIC, INC.

Practice address

1712 N Frazier St
Suite 118
Conroe, TX 77301-1347

Phone

(936) 788-6300

Fax

(866) 521-8363

NPI assigned

Apr 11, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Shante M Wilson

Title

Ceo/President

Phone

(936) 788-6300

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1334102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334102400000",
    "number": "1295092567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1712 N FRAZIER ST",
            "address_2": "SUITE 118",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773011347",
            "telephone_number": "936-788-6300",
            "fax_number": "866-521-8363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1712 N FRAZIER ST",
            "address_2": "SUITE 118",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773011347",
            "telephone_number": "936-788-6300",
            "fax_number": "866-521-8363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARCA MEDICAL CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-11",
        "last_updated": "2012-04-11",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "SHANTE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "936-788-6300"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Conroe, TX
• Providers in Conroe, TX by specialty
• General Practice Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.