NPI 1043703358

Purple Hearts Primary Care Services, PLLC

Organisation Primary Care Clinic/Center Grand Prairie, TX

Practice location

Address: 688 W Pioneer Pkwy STE 120, Grand Prairie, TX 75051-4861
Phone: (817) 969-4651
Fax: (214) 710-2188
Mailing address: 3901 Arlington Highlands Blvd STE 281, Arlington, TX 76018-6036

Authorised official

Name: Raven Modisette
Title: Ceo
Phone: (817) 969-4651

Registered specialties

Primary Care Clinic/Center Primary

Ambulatory Health Care Facilities Taxonomy 261QP2300X Licence AP137299 (TX)

Other Clinic/Center providers in Texas →

Registry record

NPI: 1043703358
Entity type: Organization
NPI issued: 11 Jun 2018
Record last updated: 7 Dec 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.