Provider Demographics
NPI:1124557319
Name:CORNERSTONE FAMILY MEDICINE, PLLC
Entity Type:Organization
Organization Name:CORNERSTONE FAMILY MEDICINE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MOLLY
Authorized Official - Middle Name:BROOKS
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:325-356-1135
Mailing Address - Street 1:408 N AUSTIN ST
Mailing Address - Street 2:
Mailing Address - City:COMANCHE
Mailing Address - State:TX
Mailing Address - Zip Code:76442-2408
Mailing Address - Country:US
Mailing Address - Phone:325-356-1135
Mailing Address - Fax:325-356-1145
Practice Address - Street 1:408 N AUSTIN ST
Practice Address - Street 2:
Practice Address - City:COMANCHE
Practice Address - State:TX
Practice Address - Zip Code:76442-2408
Practice Address - Country:US
Practice Address - Phone:817-925-0046
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-09
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty