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General NPI Number Information
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NPI Number | 1558055780
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Entity Type | Organization
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Legal Business Name | ONE FAMILY CLINIC
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Dates
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Enumeration Date | 06/08/2023
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Last Update Date | 07/13/2023
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Provider Practice Location Address
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Address Line | 2001 N LOY LAKE RD STE M
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City | SHERMAN
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State | TX
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Zip | 75090-2837
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Country | US
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Telephone | 903-618-3244
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Fax |
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Provider Business Mailing Address
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Address Line | 2001 N LOY LAKE RD STE M
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City | SHERMAN
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State | TX
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Zip | 75090-2837
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Country | US
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Telephone | 903-618-5100
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | QUYEN JOHNSON
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Credential | FNP-C
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Telephone | 903-618-3244
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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