MEDICARE: HARVEST FAMILY MEDICINE, LLP

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	173000000X	Legal Medicine	K7510	TX

General Provider Information

NPI Number	:	1760674394
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARVEST FAMILY MEDICINE, LLP

Provider Business Mailing Address
First Line	:	6009 W PARKER RD
Second Line	:	SUITE 149
City	:	PLANO
State	:	TX
Zip	:	75093-8120
Country	:	US
Telephone Number	:	972-473-9300
Fax Number	:	972-473-9300

Provider Business Practice Location Address
First Line	:	6105 WINDCOM CT
Second Line	:	SUITE 100
City	:	PLANO
State	:	TX
Zip	:	75093-7889
Country	:	US
Telephone Number	:	972-473-9300
Fax Number	:	972-473-9300

Authorized Official
Title or Position	:	OWNER
Name	:	CHANDRA L BROWN
Credential	:	M.D.
Telephone Number	:	972-473-9300

Provider Enumeration Date	:	08/17/2007
Last Update Date	:	08/12/2008

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