MEDICARE: OAKS FAMILY PRACTICE, 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	G0690	TX

General Provider Information

NPI Number	:	1942277082
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OAKS FAMILY PRACTICE, P.A.

Provider Business Mailing Address
First Line	:	25410 INTERSTATE 45 NORTH
Second Line	:	#100
City	:	SPRING
State	:	TX
Zip	:	77386
Country	:	US
Telephone Number	:	281-367-1414
Fax Number	:	281-363-5668

Provider Business Practice Location Address
First Line	:	25410 INTERSTATE 45 N
Second Line	:	#100
City	:	SPRING
State	:	TX
Zip	:	77386-1351
Country	:	US
Telephone Number	:	281-367-1414
Fax Number	:	281-363-5668

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. GARTH C. DENYER
Credential	:	M.D.
Telephone Number	:	281-367-1414

Provider Enumeration Date	:	03/08/2006
Last Update Date	:	05/28/2010

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