| Purple Hearts Integrated Community Outreach Services | |
|
688 W Pioneer Pkwy Ste 120 Grand Prairie TX 75051-4861 | |
| (214) 412-3523 | |
| (214) 710-2188 |
| Full Name | Purple Hearts Integrated Community Outreach Services |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 688 W Pioneer Pkwy Ste 120, Grand Prairie, Texas |
| Authorized Official Name and Position | Raven Elliott Modisette (CEO) |
| Authorized Official Contact | 2144123523 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Purple Hearts Integrated Community Outreach Services 688 W Pioneer Pkwy Ste 120 Grand Prairie TX 75051-4861 Ph: (214) 412-3523 | Purple Hearts Integrated Community Outreach Services 688 W Pioneer Pkwy Ste 120 Grand Prairie TX 75051-4861 Ph: (214) 412-3523 |
| NPI Number | 1962181370 |
|---|---|
| Provider Enumeration Date | 07/13/2023 |
| Last Update Date | 07/13/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962181370 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |
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