CENTER CARE CLINIC PLLC. NPI 1972391886

NPI Information

  • NPI: 1972391886
  • Provider Name: CENTER CARE CLINIC PLLC.
  • Classification: Nurse Practitioner - 363LP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • CLIA Number: 45D2324720
  • Address: 1738 S JACKSON ST
    JACKSONVILLE, TX
    ZIP 75766
  • Phone: (903) 787-2219

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NPI Details

CENTER CARE CLINIC PLLC. is a primary care nurse practitioner in Jacksonville, TX. CENTER CARE CLINIC PLLC. NPI is 1972391886. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1738 S JACKSON ST
JACKSONVILLE, TX
ZIP 75766-831
Phone: (903) 787-2219

The provider's authorized official is Chaquarra Lastaysha Mitchell .
The authorized official title is Chief Executive Officer and has the following contact phone number (903) 787-2219.

The CLIA number assigned to this NPI record is 45D2324720 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/29/2025 and was last updated on 4/29/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP2300XNurse PractitionerPrimary CareYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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