| Organization Name: | ARCA MEDICAL CLINIC, INC. |
| NPI Number: | 1295092567 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SHANTE M WILSON (CEO/PRESIDENT) |
| Mailing Address: | 1712 N Frazier St Suite 118 Conroe |
| State: | TX US |
| Postal Code: | 773011347 |
| Phone Number: | 9367886300 |
| Fax Number: | 8665218363 |
| NPI Enumeration Date: | 04/11/2012 |
| NPI Last Update Date: | 04/11/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |