Provider Demographics
NPI:1538582481
Name:AMERICAN CARESOURCE HOLDINGS, INC
Entity type:Organization
Organization Name:AMERICAN CARESOURCE HOLDINGS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROVIDER RELATIONS CREDENTIALING
Authorized Official - Prefix:MS
Authorized Official - First Name:EMORY
Authorized Official - Middle Name:J
Authorized Official - Last Name:HOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MHR
Authorized Official - Phone:972-308-6861
Mailing Address - Street 1:5429 LBJ FWY
Mailing Address - Street 2:SUITE 700
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-2607
Mailing Address - Country:US
Mailing Address - Phone:972-308-6861
Mailing Address - Fax:214-224-0187
Practice Address - Street 1:5429 LBJ FWY
Practice Address - Street 2:SUITE 700
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-2607
Practice Address - Country:US
Practice Address - Phone:972-308-6861
Practice Address - Fax:214-224-0187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-29
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization