Provider Demographics
NPI:1245898808
Name:PRIMARY CARE ANYWHERE, PLLC
Entity type:Organization
Organization Name:PRIMARY CARE ANYWHERE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GARRETT
Authorized Official - Middle Name:BENJAMIN
Authorized Official - Last Name:ROY
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:409-767-9285
Mailing Address - Street 1:4347 PHELAN
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77707
Mailing Address - Country:US
Mailing Address - Phone:409-767-9285
Mailing Address - Fax:
Practice Address - Street 1:4347 PHELAN
Practice Address - Street 2:SUITE 101
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77707
Practice Address - Country:US
Practice Address - Phone:409-767-9285
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-30
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty