Organization Active NPI

Camelot Health Care Corporation

  • Physical Therapy Clinic/Center
  • Grand Prairie, TX
National Provider Identifier
1417167644
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
1002459 Issued in TX
Legal business name
CAMELOT HEALTH CARE CORPORATION
Doing business as
CARE Clinic
Practice address
310 E Pioneer Pkwy
Grand Prairie, TX 75051-4940
Phone
(972) 264-1556
Fax
(972) 264-1565
NPI assigned
May 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Marino Gonzalez
Title
Accounting
Phone
(972) 264-1556

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 1002459 TX Primary

Addresses

Primary practice location

310 E Pioneer Pkwy
Grand Prairie, TX 75051-4940

Mailing address

310 E Pioneer Pkwy
Grand Prairie, TX 75051-4940
Phone (972) 264-1556

Other names 1

  • CARE Clinic Doing business as

National Provider Directory

National Provider Directory

Locations

310 E Pioneer Pkwy
Grand Prairie, TX 75051
Phone (972) 264-1556

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417167644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 E PIONEER PKWY",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750514940",
            "telephone_number": "972-264-1556",
            "fax_number": "972-264-1565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 E PIONEER PKWY",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750514940",
            "telephone_number": "972-264-1556",
            "fax_number": "972-264-1565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMELOT HEALTH CARE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "MARINO",
        "authorized_official_title_or_position": "ACCOUNTING",
        "authorized_official_telephone_number": "972-264-1556",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "TX",
            "license": "1002459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CARE Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Prairie, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.