Organization
PATIENT ACCESS FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTONIO DENARD INGRAM APRN,NP-C,FNP-BC (CEO)
(903) 417-5377
Entity
Organization
Contact information
Practice address
118 WOOD ST, 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
251K00000X
Public Health or Welfare Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261Q00000X
Clinic/Center
—
—
Other
Enumeration date
02/26/2022
Last updated
02/26/2022
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