SHOTS ON SITE LLC


Address: 3671 Broadway Blvd Ste 400, Garland, TX 75043-1686
Phone: 9728400001

SHOTS ON SITE LLC (NPI# 1952788317) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1952788317
Entity Type Organization
Organization Name SHOTS ON SITE LLC
Practice Address 3671 Broadway Blvd Ste 400
Garland
TX 75043-1686
Practice Telephone 9728400001
Mailing Telephone 9728400001
Enumeration Date 2015-05-05
Last Update Date 2015-05-05
Authorized Official Name ANDREW K CUMMINGS (OWNER)
Authorized Official Telephone 9728400001
Authorized Official Credential RPH
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QM1300X Clinic/Center
Specialization: Multi-Specialty
Ambulatory Health Care Facilities

Office Location

Street Address 3671 BROADWAY BLVD STE 400
City GARLAND
State TX
Zip Code 75043-1686

Providers in the same location

NPI Name Taxonomy Address Enumeration
1902878770 Mary Kathryn Hood Family Medicine 3671 Broadway Blvd Ste 400, Garland, TX 75043-1686 2006-02-06

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NPI Name Taxonomy Address Enumeration
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1841740065 Francesca Crye Anokwute Nurse Practitioner 4514 Grantham Drive, Garland, TX 75043 2016-10-12
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1992149306 Richard Shad Hattaway Dentist 6452 Broadway Boulevard, Garland, TX 75043 2013-04-29
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Taxonomy Information

Taxonomy Code 261QM1300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Multi-Specialty

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1063524049 Rakiya Engo Diallo Clinic/Center 3334 Broadway Blvd, Suite 422, Garland, TX 75043-1585 2006-08-31

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Competitor

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City GARLAND
Zip Code 75043

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Dataset Information

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.

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