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General NPI Number Information
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NPI Number | 1548451255
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Entity Type | Organization
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Legal Business Name | FIRST FAMILY CLINIC, INC.
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Dates
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Enumeration Date | 08/07/2007
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Last Update Date | 08/07/2007
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Provider Practice Location Address
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Address Line | 4805 FREDRICKSBURG ROAD
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City | SAN ANTONIO
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State | TX
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Zip | 78229
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Country | US
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Telephone | 210-979-7999
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Fax |
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Provider Business Mailing Address
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Address Line | 4805 FREDRICKSBURG ROAD
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City | SAN ANTONIO
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State | TX
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Zip | 78229
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Country | US
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Telephone | 210-979-7999
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | HONG WANG
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Credential |
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Telephone | 21097979999
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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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