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NPI Code Detail

MEDICARE: FMC LONG-TERM CARE, P.A.

MEDICARE: FMC LONG-TERM CARE, P.A.
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
1363LF0000XFamily Nurse Practitioner
2207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1538703459
Entity Type Code : Organization
Provider Name (Legal Business Name) : FMC LONG-TERM CARE, P.A.
Provider Business Mailing Address
First Line : 2501 LAKEVIEW DR
Second Line :
City : AMARILLO
State : TX
Zip : 79109-1531
Country : US
Telephone Number : 806-355-8900
Fax Number :
Provider Business Practice Location Address
First Line : 2501 LAKEVIEW DR
Second Line :
City : AMARILLO
State : TX
Zip : 79109-1531
Country : US
Telephone Number : 806-358-9400
Fax Number :
Authorized Official
Title or Position : CEO
Name : STEVE SMITH
Credential :
Telephone Number : 806-355-8900
Provider Enumeration Date : 11/04/2019
Last Update Date : 05/12/2022

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