Provider Demographics
NPI:1275125338
Name:WARBURTON FAMILY PRACTICE PLLC
Entity Type:Organization
Organization Name:WARBURTON FAMILY PRACTICE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:WARBURTON
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:281-818-7503
Mailing Address - Street 1:2510 WIGWAM PKWY STE 102
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-7115
Mailing Address - Country:US
Mailing Address - Phone:702-283-2552
Mailing Address - Fax:
Practice Address - Street 1:2510 WIGWAM PKWY STE 102
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7115
Practice Address - Country:US
Practice Address - Phone:702-283-2552
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-09
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty