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General NPI Number Information
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NPI Number | 1811102981
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Entity Type | Organization
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Legal Business Name | PRESTON FAMILY MEDICAL CLINIC
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Dates
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Enumeration Date | 05/11/2007
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Last Update Date | 02/13/2025
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Provider Practice Location Address
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Address Line | 1122 E AUSTIN ST
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City | PARIS
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State | TX
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Zip | 75460-0424
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Country | US
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Telephone | 903-783-1999
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Fax | 903-783-1167
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Provider Business Mailing Address
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Address Line | 1122 E AUSTIN ST
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City | PARIS
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State | TX
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Zip | 75460-0424
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Country | US
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Telephone | 903-783-1999
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Fax | 903-783-1167
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Authorized Official
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Title or Position | CO-OWNER
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Name | DONNA WOMACK
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Credential | FNP
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Telephone | 903-783-1999
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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 | 227977
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 629913
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License Number State | TX
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