Provider Demographics
NPI:1174132559
Name:PREVICARE, PLLC
Entity type:Organization
Organization Name:PREVICARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWED
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:917-974-7993
Mailing Address - Street 1:2006 W CAMPBELL RD STE 300
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75044-2315
Mailing Address - Country:US
Mailing Address - Phone:972-210-0688
Mailing Address - Fax:
Practice Address - Street 1:2006 W CAMPBELL RD STE 300
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75044-2315
Practice Address - Country:US
Practice Address - Phone:972-210-0688
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-30
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty