Healthcare Provider Details

I. General information

NPI: 1447169362
Provider Name (Legal Business Name): ATLANTIC FAMILY HEALTHCARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8101 ROUGHRIDER DR
WINDCREST TX
78239-2428
US

IV. Provider business mailing address

8101 ROUGHRIDER DR
WINDCREST TX
78239-2428
US

V. Phone/Fax

Practice location:
  • Phone: 210-657-3700
  • Fax: 210-657-3708
Mailing address:
  • Phone: 210-973-5714
  • Fax: 210-973-5737

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ANN DEGRASSI
Title or Position: CREDENTIALING DIRECTOR
Credential:
Phone: 210-248-7308