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NPI Code Detail

MEDICARE: FAMILY MEDICINE CENTER OF PAMPA PLLC

MEDICARE: FAMILY MEDICINE CENTER OF PAMPA PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician
2208600000XSurgery Physician
3363LF0000XFamily Nurse Practitioner
4207Q00000XFamily Medicine Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
500L20LOTHERTXRAILROAD MEDICARE GROUP

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2R17034OTHERTXRADIOLOGY
300L20LOTHERTXBCBS
445D0864498OTHERTXCLIA

General Provider Information

NPI Number : 1174556187
Entity Type Code : Organization
Provider Name (Legal Business Name) : FAMILY MEDICINE CENTER OF PAMPA PLLC
Provider Business Mailing Address
First Line : 3023 PERRYTON PKWY
Second Line : SUITE 101
City : PAMPA
State : TX
Zip : 79065-2817
Country : US
Telephone Number : 806-665-0801
Fax Number : 806-665-8503
Provider Business Practice Location Address
First Line : 3023 PERRYTON PKWY
Second Line : SUITE 101
City : PAMPA
State : TX
Zip : 79065-2821
Country : US
Telephone Number : 806-665-0801
Fax Number : 806-665-8503
Authorized Official
Title or Position : ADMINISTRATOR
Name : KATHY CRAWFORD
Credential :
Telephone Number : 806-665-0801
Provider Enumeration Date : 07/10/2006
Last Update Date : 08/22/2008

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Directions to “FAMILY MEDICINE CENTER OF PAMPA PLLC ” Practice Location

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