MEDICARE: HOBBS FAMILY PRACTICE LLC

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	207Q00000X	Family Medicine Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CK2928	OTHER	TX	MEDICARE B RAILROAD

General Provider Information

NPI Number	:	1558558650
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOBBS FAMILY PRACTICE LLC

Provider Business Mailing Address
First Line	:	PO BOX 2175
Second Line	:
City	:	PALESTINE
State	:	TX
Zip	:	75802-2175
Country	:	US
Telephone Number	:	903-731-9300
Fax Number	:

Provider Business Practice Location Address
First Line	:	5419 N LOVINGTON
Second Line	:	STE 5
City	:	HOBBS
State	:	NM
Zip	:	88240-9135
Country	:	US
Telephone Number	:	505-492-0045
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	LIN STEWART
Credential	:
Telephone Number	:	903-731-9300

Provider Enumeration Date	:	10/02/2007
Last Update Date	:	11/27/2007

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Directions to “HOBBS FAMILY PRACTICE LLC ” Practice Location

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