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General NPI Number Information
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NPI Number | 1316475726
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Entity Type | Organization
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Legal Business Name | MEDEX FAMILY HEALTH CLINIC INC
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Dates
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Enumeration Date | 05/30/2017
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Last Update Date | 03/28/2022
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Provider Practice Location Address
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Address Line | 410 E CAMP WISDOM RD STE 408
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City | DUNCANVILLE
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State | TX
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Zip | 75116-2708
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Country | US
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Telephone | 817-719-6092
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Fax |
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Provider Business Mailing Address
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Address Line | 5323 W COVE WAY
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City | GRAND PRAIRIE
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State | TX
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Zip | 75052-8631
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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 | APRN, FNP-C
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Name | FRANCISCA ANINYE
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Credential |
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Telephone | 817-719-6092
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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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 | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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