# ACTON MEDICAL CLINIC PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619928397
- **Authorized official:** PAUL STEPHEN BISHOP DO (OWNER)
- **Authorized official phone:** (817) 326-3440

## Contact information

- **Practice address:** 2006 FALL CREEK HWY, GRANBURY, TX 76049-7913
- **Practice address phone:** (817) 326-3440
- **Mailing address:** PO BOX 5334, GRANBURY, TX 76049-0334
- **Mailing address phone:** (817) 326-3440

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/15/2006
- **Last updated:** 08/16/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 00298R | BCBS GROUP NUMBER | TX |
| 05 | — | 142421001 | — | TX |
| 01 | — | DD0227 | MEDICARE RR GROUP NUMBER | — |