Healthcare Provider Details

I. General information

NPI: 1205216462
Provider Name (Legal Business Name): FAMILIA CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2015
Last Update Date: 07/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

941 E. PARK ROW
ARLINGTON TX
76010-4508
US

IV. Provider business mailing address

222 LAS COLINAS BLVD W STE 2000
IRVING TX
75039-5421
US

V. Phone/Fax

Practice location:
  • Phone: 817-522-0221
  • Fax: 817-522-0401
Mailing address:
  • Phone: 972-957-3000
  • Fax: 469-341-0488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number29998
License Number StateTX

VIII. Authorized Official

Name: CHRISTY VEDIA
Title or Position: SR. DIRECTOR OF OPERATIONS
Credential:
Phone: 972-957-3000