MEDICARE: F & K FAMILY PRACTICE PLLC

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	261QP2300X	Primary Care Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1124610712	OTHER	TX	NPI

General Provider Information

NPI Number	:	1508686775
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	F & K FAMILY PRACTICE PLLC

Provider Business Mailing Address
First Line	:	5900 BALCONES DR # 16875
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78731-4257
Country	:	US
Telephone Number	:	832-656-8769
Fax Number	:

Provider Business Practice Location Address
First Line	:	18350 TIMBER FOREST DR # 200
Second Line	:
City	:	HUMBLE
State	:	TX
Zip	:	77346-2957
Country	:	US
Telephone Number	:	832-656-8769
Fax Number	:

Authorized Official
Title or Position	:	FNP
Name	:	KENIA ROMAN ARIAS
Credential	:	FNP
Telephone Number	:	832-656-8769

Provider Enumeration Date	:	10/14/2024
Last Update Date	:	10/14/2024

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