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General NPI Number Information
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NPI Number | 1558983197
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Entity Type | Organization
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Legal Business Name | PRIORITY FAMILY HEALTHCARE LLC
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Dates
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Enumeration Date | 05/16/2020
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Last Update Date | 06/08/2021
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Provider Practice Location Address
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Address Line | 1743 SOUTHVIEW CIR
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City | CENTER
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State | TX
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Zip | 75935-9324
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Country | US
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Telephone | 903-692-3219
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1749
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City | CENTER
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State | TX
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Zip | 75935-1749
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Country | US
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Telephone | 936-590-4708
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Fax | 936-590-4815
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Authorized Official
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Title or Position | OWNER
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Name | MRS. CARRISTON RENEE HENDRICKS
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Credential | FNP-C
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Telephone | 936-590-4708
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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