GRAND PRAIRIE PROFESSIONAL GROUP, P. A. (NPI# 1871850750) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871850750 |
| Entity Type | Organization |
| Organization Name | GRAND PRAIRIE PROFESSIONAL GROUP, P. A. |
| Practice Address |
1171 107th St Grand Prairie TX 75050-2502 |
| Mailing Address |
115 Penn Warren Dr Suite 300-280 Brentwood TN 37027-5047 |
| Practice Telephone | 6157278387 |
| Practice Fax Number | 6154578094 |
| Mailing Telephone | 6157278387 |
| Mailing Fax Number | 6154578094 |
| Enumeration Date | 2012-04-18 |
| Last Update Date | 2015-08-24 |
| Authorized Official Name | DR. MARK A. CALARCO (PRESIDENT, SECRETARY AND TREASURER) |
| Authorized Official Telephone | 6157278387 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0802X |
Psychiatry & Neurology Specialization: Addiction Psychiatry |
E1948 | TX | Allopathic & Osteopathic Physicians |
| Street Address |
1171 107TH ST |
| City | GRAND PRAIRIE |
| State | TX |
| Zip Code | 75050-2502 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750536462 | Angelica Torres Yrigollen | Nurse Practitioner | 1171 107th St, Grand Prairie, TX 75050-2502 | 2008-11-21 |
| 1962012146 | Audra Coston | Nurse Practitioner | 1171 107th St, Grand Prairie, TX 75050-2502 | 2020-08-03 |
| 1639562093 | Monique Fincannon | Nurse Practitioner | 1171 107th St, Grand Prairie, TX 75050-2502 | 2015-03-10 |
| 1063786069 | Greenhouse Treatment Center, LLC | Clinic/Center | 1171 107th St, Grand Prairie, TX 75050 | 2012-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225539695 | Christopher Bachman | Physical Therapy Assistant | 2045 Hwy 360, #100b, Grand Prarie, TX 75050 | 2018-02-21 |
| 1003335233 | L & B Group Home LLC | In Home Supportive Care | 605 E Palace Pkwy Ste, B4, Grand Prairie, TX 75050 | 2017-09-19 |
| 1073054748 | Smileeasy Dental Grand Prairie, Pllc | Dentist | 2650 S Hwy 161, Grand Prairie, TX 75050 | 2017-03-15 |
| 1164966651 | Prime Diagnostic Imaging of Irving, LLC | Clinic/Center | 2210 Paddock Way, Grand Prairie, TX 75050 | 2016-12-19 |
| 1366801037 | Monica Simpson | Counselor | 2080 N Hwy 360, Ste 430, Grand Prairie, TX 75050 | 2016-02-23 |
| 1437545845 | Stateserv Medical of Texas | Durable Medical Equipment & Medical Supplies | 1000 Post and Paddock Street, #305, Grand Prairie, TX 75050 | 2015-04-13 |
| 1912304593 | Tenishia Chintankwa | Non-emergency Medical Transport (VAN) | 2403 Doreen St, Grand Prairie, TX 75050 | 2014-11-26 |
| 1780023192 | Holland Surgical Group | Physician Assistant | 201 West Tarrant Rd. #1420, Grand Prairie, TX 75050 | 2013-06-19 |
| 1174962823 | Occumed Plus-grand Prairie | General Practice | 805 W. North Carrier Pkwy, 260, Grand Prairie, TX 75050 | 2013-06-17 |
| 1497099618 | Sorai Susanne S Stuart | Counselor | 2825 N. State Hwy 360, 710, Grand Prairie, TX 75050 | 2012-11-15 |
| Find all providers in zip 75050 | ||||
| Taxonomy Code | 2084P0802X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Addiction Psychiatry |
| Addiction Psychiatry is a subspecialty of psychiatry that focuses on evaluation and treatment of individuals with alcohol, drug, or other substance-related disorders, and of individuals with dual diagnosis of substance-related and other psychiatric disorders. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427666353 | Fresh Start Psychiatric Clinic | Psychiatry & Neurology | 9843 Blaine Lake Dr, Houston, TX 77086-2878 | 2020-07-16 |
| 1558776138 | Ivanshu Navinprakash Jain | Psychiatry & Neurology | Terrell State Hospital, 1200 E Brin St, Terrell, TX 75160 | 2014-06-23 |
| 1558592428 | Padmaja Puppala | Psychiatry & Neurology | 2116 Canyon Park Dr, Southlake, TX 76092 | 2009-07-27 |
| 1710143813 | Professional Medical Services | Psychiatry & Neurology | 35 Juniper Grove Pl, The Woodlands, TX 77382-4403 | 2008-07-29 |
| 1679609093 | Julie Ross Pittman | Psychiatry & Neurology | 3602 Matlock Rd Ste 210, Arlington, TX 76015-3600 | 2007-02-27 |
| 1033263009 | John R Marshall | Psychiatry & Neurology | 1107 N Cooper St, Arlington, TX 76011-5545 | 2007-01-23 |
| 1760536999 | Robert B Hunter | Psychiatry & Neurology | 2404 Kingston St, Houston, TX 77019-6604 | 2007-01-23 |
| 1487731758 | Beth Kratochvil Boyarsky | Psychiatry & Neurology | 711 N College St, Georgetown, TX 78626 | 2006-11-01 |
| 1801972385 | Robert Storey Wilson Sr. | Psychiatry & Neurology | 1100 N Mccart St, Stephenville, TX 76401-2430 | 2006-10-27 |
| 1427064062 | Luz Starck | Psychiatry & Neurology | 12050 Vance Jackson Building 2 Suite 201, San Antonio, TX 78230 | 2006-08-01 |
| Find all providers with the same taxonomy | ||||
| City | GRAND PRAIRIE |
| Zip Code | 75050 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.