MEDICARE: FAMILY MEDICINE OF TEXAS PA

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	J9261	TX

General Provider Information

NPI Number	:	1811145808
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY MEDICINE OF TEXAS PA

Provider Business Mailing Address
First Line	:	6300 W PARKER RD
Second Line	:	SUITE 225
City	:	PLANO
State	:	TX
Zip	:	75093-8102
Country	:	US
Telephone Number	:	972-981-7822
Fax Number	:	972-981-7820

Provider Business Practice Location Address
First Line	:	6300 W PARKER RD
Second Line	:	SUITE 225
City	:	PLANO
State	:	TX
Zip	:	75093-8102
Country	:	US
Telephone Number	:	972-981-7822
Fax Number	:	972-981-7820

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SARAH N PAYBERAH
Credential	:	M.D.
Telephone Number	:	972-981-7825

Provider Enumeration Date	:	09/03/2008
Last Update Date	:	10/23/2009

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