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General NPI Number Information
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NPI Number | 1336500636
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Entity Type | Organization
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Legal Business Name | FAMILY TREE HEALTHCARE LLC
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Dates
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Enumeration Date | 03/14/2016
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 7002 S CENTRAL AVE
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City | PHOENIX
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State | AZ
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Zip | 85042-5423
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Country | US
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Telephone | 602-449-4221
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Fax | 602-268-6298
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Provider Business Mailing Address
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Address Line | 7002 S CENTRAL AVE
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City | PHOENIX
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State | AZ
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Zip | 85042-5423
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Country | US
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Telephone | 602-449-4221
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Fax | 602-268-6298
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Authorized Official
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Title or Position | PRESIDENT CLINIC OPERATIONS
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Name | HECTOR REYES
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Credential |
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Telephone | 602-499-4221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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