Healthcare Provider Details

I. General information

NPI: 1679127393
Provider Name (Legal Business Name): FAMILY FIRST EXPRESS CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2019
Last Update Date: 08/17/2020
Certification Date: 08/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1295 S HIGHWAY 183 STE 101
LEANDER TX
78641-4557
US

IV. Provider business mailing address

10319 JEFFERSON HWY
BATON ROUGE LA
70809-2730
US

V. Phone/Fax

Practice location:
  • Phone: 225-214-9352
  • Fax:
Mailing address:
  • Phone: 225-214-9352
  • Fax: 225-214-9349

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TAMARA B SAMSON
Title or Position: VP REV CYCLE SERVICES
Credential:
Phone: 225-214-1031