MEDICARE: ABILENE FAMILY HEALTH CARE, P.A.

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	F6935	TX

General Provider Information

NPI Number	:	1568617512
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABILENE FAMILY HEALTH CARE, P.A.

Provider Business Mailing Address
First Line	:	1181 LYTLE WAY
Second Line	:	SUITE F
City	:	ABILENE
State	:	TX
Zip	:	79602-4299
Country	:	US
Telephone Number	:	325-701-4818
Fax Number	:	325-701-4429

Provider Business Practice Location Address
First Line	:	1933 PINE ST
Second Line	:	SUITE B
City	:	ABILENE
State	:	TX
Zip	:	79601-2431
Country	:	US
Telephone Number	:	325-675-0338
Fax Number	:	325-672-5049

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MAXEY DELL MCKNIGHT
Credential	:	M.D.
Telephone Number	:	325-675-0338

Provider Enumeration Date	:	11/18/2008
Last Update Date	:	04/27/2009

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