Healthcare Provider Details
I. General information
NPI: 1558558650
Provider Name (Legal Business Name): HOBBS FAMILY PRACTICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/02/2007
Last Update Date: 11/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5419 N LOVINGTON STE 5
HOBBS NM
88240-9135
US
IV. Provider business mailing address
PO BOX 2175
PALESTINE TX
75802-2175
US
V. Phone/Fax
- Phone: 505-492-0045
- Fax:
- Phone: 903-731-9300
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LIN
STEWART
Title or Position: CEO
Credential:
Phone: 903-731-9300