Grand Prairie Professional Group, P. a.

Primary specialty

Addiction Psychiatry PhysicianTaxonomy code 2084P0802X

License

E1948 Issued in TX

Legal business name

GRAND PRAIRIE PROFESSIONAL GROUP, P. A.

Practice address

1171 107TH St
Grand Prairie, TX 75050-2502

Phone

(615) 727-8387

Fax

(615) 457-8094

NPI assigned

Apr 18, 2012

Organization subpart

No

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

Authorized official

Name

Mark A. Calarco, DO

Title

Facility Ceo

Phone

(615) 712-5862

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1334707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629849600000",
    "number": "1871850750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 POWELL PL",
            "address_2": "ATTN: LEGAL DEPARTMENT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277514",
            "telephone_number": "615-732-1605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1171 107TH ST",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750502502",
            "telephone_number": "615-727-8387",
            "fax_number": "615-457-8094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND PRAIRIE PROFESSIONAL GROUP, P. A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-18",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A",
        "authorized_official_last_name": "CALARCO",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "FACILITY CEO",
        "authorized_official_telephone_number": "615-712-5862",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2084P0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "TX",
            "license": "E1948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction Psychiatry Physician in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• Addiction Psychiatry Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; 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.