Organization
BEACON INTEGRATED HEALTHCARE
Active
Parent organization
PATIENT ACCESS FOUNDATION
Organization subpart
Yes
Provider details
NPI number
Legal business name
PATIENT ACCESS FOUNDATION
Authorized official
MR. ANTONIO D. INGRAM FNP-BC (CEO)
(903) 417-5377
Entity
Organization
Contact information
Practice address
118 WOOD ST OFC 1, DE KALB, TX 75559-2112
(903) 417-5377
Mailing address
PO BOX 369, DE KALB, TX 75559-0369
(903) 417-5377
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QR1300X
Rural Health Clinic/Center
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
02/11/2022
Last updated
02/11/2022
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