Healthcare Provider Details

I. General information

NPI: 1679655153
Provider Name (Legal Business Name): DUMAS FAMILY PRACTICE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 10/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 BEARD AVE
DUMAS TX
79029-4003
US

IV. Provider business mailing address

PO BOX 755
DUMAS TX
79029-0755
US

V. Phone/Fax

Practice location:
  • Phone: 806-935-9005
  • Fax: 806-395-5885
Mailing address:
  • Phone: 806-935-9005
  • Fax: 806-935-5885

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License NumberH8594
License Number StateTX

VIII. Authorized Official

Name: MR. CHRIS L BUNCH
Title or Position: OWNER
Credential: MD
Phone: 806-935-9005