Organization
CITIMED, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. POHN PAUL INTHANOUSAY D.O. (OWNER)
(817) 572-9890
Entity
Organization
Contact information
Practice address
4401 LITTLE RD STE 520, ARLINGTON, TX 76016-5621
(817) 572-9890
(817) 572-9887
Mailing address
4401 LITTLE RD STE 520, ARLINGTON, TX 76016-5621
(817) 572-9890
(817) 572-9887
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
J9103
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
139893530
—
TX
01
—
8H8600
BLUECROSS AND BLUESHIELD
TX
Enumeration date
02/25/2008
Last updated
06/06/2011
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