Provider Demographics
NPI:1093453201
Name:TLC FAMILY CLINIC PLLC
Entity Type:Organization
Organization Name:TLC FAMILY CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FRONT OFFICE
Authorized Official - Prefix:
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:DELEON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-313-6278
Mailing Address - Street 1:230 PARKING WAY ST
Mailing Address - Street 2:
Mailing Address - City:LAKE JACKSON
Mailing Address - State:TX
Mailing Address - Zip Code:77566-5227
Mailing Address - Country:US
Mailing Address - Phone:979-313-6278
Mailing Address - Fax:979-401-4175
Practice Address - Street 1:230 PARKING WAY ST
Practice Address - Street 2:
Practice Address - City:LAKE JACKSON
Practice Address - State:TX
Practice Address - Zip Code:77566-5227
Practice Address - Country:US
Practice Address - Phone:979-313-6278
Practice Address - Fax:979-401-4175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-26
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care