Provider Demographics
NPI:1164123014
Name:FAMILY CARE OF HENDERSON, PLLC
Entity Type:Organization
Organization Name:FAMILY CARE OF HENDERSON, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:IFFLAND
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, FNP-C
Authorized Official - Phone:903-392-0005
Mailing Address - Street 1:321 WILSON ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:TX
Mailing Address - Zip Code:75652-5957
Mailing Address - Country:US
Mailing Address - Phone:903-392-0005
Mailing Address - Fax:903-392-7772
Practice Address - Street 1:321 WILSON ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:TX
Practice Address - Zip Code:75652-5957
Practice Address - Country:US
Practice Address - Phone:903-392-0005
Practice Address - Fax:903-392-7772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-16
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty