Provider Demographics
NPI:1194724898
Name:ESSENT PRMC LP
Entity type:Organization
Organization Name:ESSENT PRMC LP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:W
Authorized Official - Last Name:BROWDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-312-5103
Mailing Address - Street 1:PO BOX 9070
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75461-9070
Mailing Address - Country:US
Mailing Address - Phone:903-737-3257
Mailing Address - Fax:903-737-3375
Practice Address - Street 1:605 NORTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:BOGATA
Practice Address - State:TX
Practice Address - Zip Code:75417-0540
Practice Address - Country:US
Practice Address - Phone:903-632-9102
Practice Address - Fax:903-632-9910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX165477401Medicaid
TX458818Medicare ID - Type Unspecified