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NPI Code Detail

MEDICARE: TEAGUE FAMILY SERVICES, INC.

MEDICARE: TEAGUE FAMILY SERVICES, INC.
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
1207Q00000XFamily Medicine PhysicianK1753TX

General Provider Information

NPI Number : 1225231574
Entity Type Code : Organization
Provider Name (Legal Business Name) : TEAGUE FAMILY SERVICES, INC.
Provider Business Mailing Address
First Line : 933 LAKE AIR DR
Second Line : PO BOX 8727
City : WACO
State : TX
Zip : 76710-4548
Country : US
Telephone Number : 254-772-3700
Fax Number : 254-772-3705
Provider Business Practice Location Address
First Line : 933 LAKE AIR DR
Second Line :
City : WACO
State : TX
Zip : 76710-4548
Country : US
Telephone Number : 254-772-3700
Fax Number : 254-772-3705
Authorized Official
Title or Position : PRESIDENT
Name : SHEILA Y. LONG
Credential :
Telephone Number : 254-772-3700
Provider Enumeration Date : 06/06/2007
Last Update Date : 12/29/2008

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Directions to “TEAGUE FAMILY SERVICES, INC. ” Practice Location

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