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Organization

ACS PRIMARY CARE PHYSICIANS SOUTHWEST, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SHARON HARDY (PROVIDER ENROLLMENT DIRECTOR)
(925) 251-6901
Entity
Organization

Contact information

Practice address
1900 HOSPITAL BLVD, GAINESVILLE, TX 76240-2002
(925) 924-1600
Mailing address
5000 HOPYARD RD, SUITE 100, PLEASANTON, CA 94588-3348
(925) 924-1600

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
207Q00000X
Family Medicine Physician
207R00000X
Internal Medicine Physician
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
208M00000X
Hospitalist Physician
363A00000X
Physician Assistant
363L00000X
Nurse Practitioner
363LF0000X
Family Nurse Practitioner
363LP0200X
Pediatric Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0019LM
BCBS OF TEXAS
TX
01
0096MG
TEXAS BCBS
TX
05
170873701
TX
05
170873702
TX
05
170873704
TX
05
170873705
TX
01
DC7040
PALMETTO GOVERNMENT BENEF
TX
01
DC7459
MEDICARE RR - PALMETTO
TX
01
DC8546
PALMETTO GOVERNMENT BENEF
TX
01
DD7728
MEDICARE RR - PALMETTO
TX
Enumeration date
06/11/2006
Last updated
02/20/2020
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