Provider Demographics
NPI:1154329795
Name:PHYSICIANS CARING FOR PEOPLE
Entity Type:Organization
Organization Name:PHYSICIANS CARING FOR PEOPLE
Other - Org Name:FAMILY HEALTHCARE OF EAST TX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOY
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-526-6963
Mailing Address - Street 1:1304 DOCTORS DR
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-2262
Mailing Address - Country:US
Mailing Address - Phone:903-526-6963
Mailing Address - Fax:903-531-2320
Practice Address - Street 1:1304 DOCTORS DR
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-2262
Practice Address - Country:US
Practice Address - Phone:903-526-6963
Practice Address - Fax:903-531-2320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-08
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK2341207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX150860801Medicaid
TX00417TMedicare PIN
TX150860801Medicaid