MEDICARE: VIP FAMILY MEDICINE ASSOCIATES, LLC

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
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1629152459
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIP FAMILY MEDICINE ASSOCIATES, LLC

Provider Business Mailing Address
First Line	:	1200 WALLACE BLVD
Second Line	:	SUITE C
City	:	AMARILLO
State	:	TX
Zip	:	79106-1741
Country	:	US
Telephone Number	:	806-359-9000
Fax Number	:	806-350-7905

Provider Business Practice Location Address
First Line	:	1200 WALLACE BLVD
Second Line	:	SUITE C
City	:	AMARILLO
State	:	TX
Zip	:	79106-1741
Country	:	US
Telephone Number	:	806-359-9000
Fax Number	:	806-350-7905

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. LEE J FRIEND
Credential	:	MD
Telephone Number	:	806-359-9000

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	08/22/2020

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