Healthcare Provider Details

I. General information

NPI: 1780201053
Provider Name (Legal Business Name): TRI-COUNTY FAMILY MEDICINE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2020
Last Update Date: 02/02/2026
Certification Date: 02/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 W MAIN ST STE C
GUN BARREL CITY TX
75156-5404
US

IV. Provider business mailing address

126 W MAIN ST STE C
GUN BARREL CITY TX
75156-5404
US

V. Phone/Fax

Practice location:
  • Phone: 903-887-1092
  • Fax:
Mailing address:
  • Phone: 903-887-1092
  • Fax: 903-887-2051

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 Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: JULIE NELL KILCREASE
Title or Position: OWNER
Credential: FNP
Phone: 903-887-1092