Provider Demographics
NPI:1164744660
Name:FAMICARE CLINIC, PA
Entity Type:Organization
Organization Name:FAMICARE CLINIC, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HUY
Authorized Official - Middle Name:QUOC
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-804-4138
Mailing Address - Street 1:2445 CHESAPEAKE DR
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-1497
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3465 W WALNUT ST
Practice Address - Street 2:SUITE 225
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-7153
Practice Address - Country:US
Practice Address - Phone:972-272-7816
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-24
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN3945261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care