EVERGREEN TESTOSTERONE CLINIC & PRIMARY CARE (NPI# 1942710256) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942710256 |
| Entity Type | Organization |
| Organization Name | EVERGREEN TESTOSTERONE CLINIC & PRIMARY CARE |
| Practice Address |
619 Matlock Centre Cir Arlington TX 76015-2535 |
| Practice Telephone | 2148700885 |
| Mailing Telephone | 2148700885 |
| Enumeration Date | 2017-10-02 |
| Last Update Date | 2017-10-02 |
| Authorized Official Name | KEN WAMWIRI (PRESIDENT AND CEO) |
| Authorized Official Telephone | 2148700885 |
| Authorized Official Credential | FNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Street Address |
619 MATLOCK CENTRE CIR |
| City | ARLINGTON |
| State | TX |
| Zip Code | 76015-2535 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407358955 | Shavon Ohiomu | Licensed Vocational Nurse | 3402 Timberwood Circle Apt 2130, Arlington, TX 76015 | 2018-03-01 |
| 1194235580 | In Balance In Control, L.L.C. | Massage Therapist | 1402 W Mayfield Rd, Suite 420, Arlington, TX 76015 | 2017-10-11 |
| 1063922458 | Kenneth Eugene Frey II | Massage Therapist | 1402 West Mayfield Road, Suite 420, Arlington, TX 76015 | 2017-10-11 |
| 1285181263 | U S Anesthesia Partners of Texas, Pa | Nurse Practitioner | 800 W Arbrook, Suite 120, Arlington, TX 76015 | 2016-09-07 |
| 1659739365 | Danika Rasmussengeter | Chiropractor | 1216 Florida Dr # 130, Arlington, TX 76015 | 2016-02-09 |
| 1962809541 | Texas Rehabilitation Hospital of Arlington, LLC | Rehabilitation Hospital | 900 West Arbrook Blvd, Arlington, TX 76015 | 2014-11-26 |
| 1528470473 | Felicia Montgomery | Doula | 3903 Melear Drive, Unit 151681, Arlington, TX 76015 | 2014-05-27 |
| 1437572427 | E.s. Drugs Inc. | Pharmacy | 3295 S. Cooper Street #107, Arlington, TX 76015 | 2014-01-27 |
| 1477802890 | James Tra | Pharmacist | 1600 West Arbrook Blvd, Arlington, TX 76015 | 2012-08-30 |
| 1225397912 | Apsp-arlington, LLC | Clinical Medical Laboratory | 1348 W. Mayfield Road, Suite 200, Arlington, TX 76015 | 2012-05-15 |
| Find all providers in zip 76015 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265047666 | Np Healthcare Associates, LLC | Clinic/Center | 1901 Southeast Pkwy Ste 101, Arlington, TX 76018-3605 | 2020-09-11 |
| 1972154656 | Careatc | Clinic/Center | 3050 S Center St Ste 130, Arlington, TX 76014-2154 | 2019-09-24 |
| 1588102743 | Hope In My Hands, Inc. | Clinic/Center | 1117 W Pioneer Pkwy Ste 120, Arlington, TX 76013-6397 | 2017-02-08 |
| 1194124685 | Paul Thompson Pa | Clinic/Center | 2000 E Lamar, Suite 155, Arlington, TX 76006 | 2014-08-20 |
| 1720343692 | Meddok Preventive Medicine Clinic | Clinic/Center | 1216 Florida Dr # 120, Arlington, TX 76015-2387 | 2012-07-06 |
| 1033425376 | Paula Jacqueline Clarke | Clinic/Center | 47 Melrose St, Arlington, MA 02474-8503 | 2010-08-24 |
| 1982933305 | Anjani Amin, Md, Pa | Clinic/Center | 1110 E Bardin Rd, Suite 100, Arlington, TX 76018-1212 | 2009-12-14 |
| 1629275003 | Arlington Family Practice, Inc. | Clinic/Center | 906 N. Main Street, Arlington, OH 45814-0319 | 2007-06-29 |
| 1588129167 | Clinic for Less Home Visit | Clinic/Center | 2000 E Lamar Blvd Ste 600, Arlington, TX 76006-7361 | 2019-02-07 |
| 1043703358 | Purple Hearts Primary Care Services, Pllc | Clinic/Center | 3901 Arlington Highlands Blvd Ste 200, Arlington, TX 76018 | 2018-06-11 |
| Find all providers in ARLINGTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.