NACOGDOCHES FAMILY PRACTICE PA NPI 1235317082

NPI Information

NPI: 1235317082
Provider Name: NACOGDOCHES FAMILY PRACTICE, PA
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
1023 N MOUND ST
SUITE A
NACOGDOCHES, TX
ZIP 75961
Phone: (936) 564-2691
Get Directions

NACOGDOCHES FAMILY PRACTICE, PA is a family medicine in Nacogdoches, TX. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. NACOGDOCHES FAMILY PRACTICE, PA NPI is 1235317082. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1023 N MOUND ST
SUITE A
NACOGDOCHES, TX
ZIP 75961-491
Phone: (936) 564-2691
Fax: (936) 560-5224

The provider's authorized official is Edwin Emborgo .
The authorized official title is Owner and has the following contact phone number (936) 564-2691.

The enumeration date for this NPI number is 2/4/2008 and was last updated on 6/22/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	I52265	MEDICARE UPIN	TEXAS
2	M8458	OTHER	TEXAS	TEXAS MEDICAL LICENSE
3	203713701	MEDICAID	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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