Provider Demographics
NPI:1225745573
Name:MARBLE FALLS PRIMARY CARE, PLLC
Entity Type:Organization
Organization Name:MARBLE FALLS PRIMARY CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP-C/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SUTHERLAND
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:512-966-6385
Mailing Address - Street 1:1107 AVENUE K STE 100
Mailing Address - Street 2:
Mailing Address - City:MARBLE FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:78654-5010
Mailing Address - Country:US
Mailing Address - Phone:512-966-6385
Mailing Address - Fax:
Practice Address - Street 1:1107 AVENUE K STE 100
Practice Address - Street 2:
Practice Address - City:MARBLE FALLS
Practice Address - State:TX
Practice Address - Zip Code:78654-5010
Practice Address - Country:US
Practice Address - Phone:512-966-6385
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-04
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service