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General NPI Number Information
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NPI Number | 1235959982
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Entity Type | Organization
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Legal Business Name | CENTERED FAMILY HEALTH CLINIC, PLLC
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Dates
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Enumeration Date | 10/16/2024
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Last Update Date | 10/16/2024
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Provider Practice Location Address
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Address Line | 3330 70TH ST STE 204
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City | LUBBOCK
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State | TX
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Zip | 79413-6137
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Country | US
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Telephone | 806-701-4381
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Fax | 806-701-4382
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Provider Business Mailing Address
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Address Line | 6923 INDIANA AVE # 301
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City | LUBBOCK
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State | TX
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Zip | 79413-6111
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOHNNY JONES
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Credential | APRN, FNP-C
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Telephone | 806-474-4392
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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