Healthcare Provider Details

I. General information

NPI: 1245321090
Provider Name (Legal Business Name): ABILENE PRIMARY CARE ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 08/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2225 S DANVILLE DR
ABILENE TX
79605-4779
US

IV. Provider business mailing address

425 CYPRESS ST
ABILENE TX
79601-5101
US

V. Phone/Fax

Practice location:
  • Phone: 325-673-2432
  • Fax: 325-627-0618
Mailing address:
  • Phone: 325-673-4488
  • Fax: 325-673-4487

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: LAURA BARBER
Title or Position: PRESIDENT
Credential: MD
Phone: 325-673-2432