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General NPI Number Information
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NPI Number | 1790971778
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Entity Type | Organization
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Legal Business Name | FAMILY MEDICAL & URGENT CARE CENTER PA
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Dates
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Enumeration Date | 09/24/2007
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Last Update Date | 10/15/2010
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Provider Practice Location Address
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Address Line | 905 FERRIS AVE
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City | WAXAHACHIE
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State | TX
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Zip | 75165-2556
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Country | US
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Telephone | 972-937-0086
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Fax | 972-923-2351
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Provider Business Mailing Address
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Address Line | 905 FERRIS AVE
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City | WAXAHACHIE
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State | TX
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Zip | 75165-2556
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Country | US
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Telephone | 972-937-0086
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Fax | 972-923-2351
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Authorized Official
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Title or Position | CHIROPRACTOR/PROPRIETOR
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Name | JOZEF P VERHAERT
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Credential | D.C.
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Telephone | 972-937-0086
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 5723
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License Number State | TX
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