Above Average Health and House Calls LLC
Organization Active NPI Adult Health Nurse Practitioner · Wilmer, TX
NPI 1760940563 · NPPES record last updated Mar 11, 2019
Key facts
- NPI
- 1760940563
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Adult Health Nurse Practitioner 363LA2200X
- Legal business name
- ABOVE AVERAGE HEALTH AND HOUSE CALLS LLC
- Practice address
- 989 Winning Colors Dr
Wilmer, TX 75172-2336 - Phone
- (469) 494-7725
- NPI assigned
- Mar 11, 2019
- Organization subpart
- No
Authorized official
- Name
- Alba Jackson
- Title
- Credentailist
- Phone
- (210) 417-4595
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190429000380 | TX | Part B Supplier - Clinic/Group Practice | 0446592281 |
Receives reassigned benefits from 1 practitioner Practice locations: Carthage, TX |
National Provider Directory
Locations
424 W Sabine St
Ste 1
Carthage, TX 75633
Phone (469) 494-7725
445 E FM 1382
Ste 3
Cedar Hill, TX 75104
Phone (214) 699-7908
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner |
363LA2200X | Yes |
Addresses
Primary practice location
989 Winning Colors Dr
Wilmer, TX 75172-2336
Mailing address
445 E FM 1382 Ste 3
Cedar Hill, TX 75104-6046
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ajackson@pcrsclaims.com |
Other providers in Wilmer, TX
All providers in Wilmer, TX · Adult Health Nurse Practitioner in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 11, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.