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	3336C0002X	Clinic Pharmacy

General Provider Information

NPI Number	:	1801140009
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILIA CARE INC.

Provider Business Mailing Address
First Line	:	300 E JOHN CARPENTER FWY STE 850
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75062-3589
Country	:	US
Telephone Number	:	972-957-3000
Fax Number	:

Provider Business Practice Location Address
First Line	:	5230 ALDINE MAIL RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77039-3804
Country	:	US
Telephone Number	:	281-598-3300
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. EDUARDO BARAJAS
Credential	:
Telephone Number	:	972-957-3000

Provider Enumeration Date	:	11/09/2012
Last Update Date	:	11/09/2012

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