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General NPI Number Information
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NPI Number | 1346527983
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Entity Type | Organization
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Legal Business Name | FAMILIA CARE INC.
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Dates
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Enumeration Date | 11/10/2011
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Last Update Date | 11/10/2011
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Provider Practice Location Address
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Address Line | 655 W. ILLINOIS AVENUE, BUILDING 900, SUITE 916/918,
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City | DALLAS
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State | TX
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Zip | 75224
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Country | US
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Telephone | 214-845-4000
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Fax | 214-942-1857
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Provider Business Mailing Address
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Address Line | 300 E JOHN CARPENTER FWY
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City | IRVING
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State | TX
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Zip | 75062-2727
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Country | US
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Telephone | 972-957-3000
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Fax |
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Authorized Official
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Title or Position | PIC
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Name | ROBERT BOATRIGHT
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Credential |
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Telephone | 214-840-0406
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 27632
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License Number State | TX
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