Provider Demographics
NPI:1043757479
Name:YOUR FAMILY HEALTHCARE, LLC
Entity Type:Organization
Organization Name:YOUR FAMILY HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NIKI
Authorized Official - Middle Name:
Authorized Official - Last Name:HODGES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-316-9085
Mailing Address - Street 1:13230 FM 1764 RD STE C
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:TX
Mailing Address - Zip Code:77510-9132
Mailing Address - Country:US
Mailing Address - Phone:409-316-9085
Mailing Address - Fax:409-316-9014
Practice Address - Street 1:13230 FM 1764 RD STE C
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:TX
Practice Address - Zip Code:77510-9132
Practice Address - Country:US
Practice Address - Phone:409-316-9085
Practice Address - Fax:409-316-9014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care