Organization
OPTIMED HEALTHCARE CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANITA CHACKO (OWNER)
(214) 205-2792
Entity
Organization
Contact information
Practice address
6321 SAN MARINO DR, ROWLETT, TX 75089-4534
(214) 205-2792
Mailing address
6321 SAN MARINO DR, ROWLETT, TX 75089-4534
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
03/24/2016
Last updated
03/24/2016
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