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NPI 1992223085 Active Family Medicine

Quick Facts

NPI Number

1992223085

Type

Organization (NPI-2)

Status

Active

Enumeration Date

2017-09-08

Last Updated (NPPES)

2017-09-08

Primary Specialty / Taxonomy

Taxonomy	Family Medicine
Taxonomy Code	`207Q00000X`

Practice Address

601 NORTHWEST PKWY STE C
AZLE, TX 760202930

Phone: 817-270-0777

Fax: 817-421-0036

Mailing Address

920 S KIMBALL AVE
SOUTHLAKE, TX 760929016

Data sourced live from the CMS NPPES NPI Registry (npiregistry.cms.hhs.gov) and cached locally. This is a public directory lookup, not a credentialing or verification service — confirm critical details directly with NPPES or the provider.