Provider Demographics
NPI:1124736442
Name:CITRA PHYSICIAN SERVICES PLLC
Entity type:Organization
Organization Name:CITRA PHYSICIAN SERVICES PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:KARR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-206-1447
Mailing Address - Street 1:7515 GREENVILLE AVE STE 900
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-3851
Mailing Address - Country:US
Mailing Address - Phone:214-206-1447
Mailing Address - Fax:469-808-0695
Practice Address - Street 1:2339 W MOCKINGBIRD LN STE 100
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-5509
Practice Address - Country:US
Practice Address - Phone:972-584-9554
Practice Address - Fax:469-808-0695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-07
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care