MEDICARE: FAMILIA CARE INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	29998	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	29998	OTHER	TX	TX BOARD LICENSE

General Provider Information

NPI Number	:	1205216462
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILIA CARE INC.

Provider Business Mailing Address
First Line	:	222 LAS COLINAS BLVD W
Second Line	:	STE 2000
City	:	IRVING
State	:	TX
Zip	:	75039-5421
Country	:	US
Telephone Number	:	972-957-3000
Fax Number	:	469-341-0488

Provider Business Practice Location Address
First Line	:	941 E. PARK ROW
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76010-4508
Country	:	US
Telephone Number	:	817-522-0221
Fax Number	:	817-522-0401

Authorized Official
Title or Position	:	SR. DIRECTOR OF OPERATIONS
Name	:	CHRISTY VEDIA
Credential	:
Telephone Number	:	972-957-3000

Provider Enumeration Date	:	06/03/2015
Last Update Date	:	07/18/2015

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Directions to “FAMILIA CARE INC. ” Practice Location

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