Provider Demographics
NPI:1346583812
Name:HOPPER MEDICAL MANAGEMENT SERVICES
Entity Type:Organization
Organization Name:HOPPER MEDICAL MANAGEMENT SERVICES
Other - Org Name:TEXAS FAMILY MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FNP-C/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:S
Authorized Official - Last Name:HOPPER
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:940-325-3706
Mailing Address - Street 1:2515 HIGHWAY 180 W STE A
Mailing Address - Street 2:
Mailing Address - City:MINERAL WELLS
Mailing Address - State:TX
Mailing Address - Zip Code:76067-8295
Mailing Address - Country:US
Mailing Address - Phone:940-325-3706
Mailing Address - Fax:940-325-6200
Practice Address - Street 1:2515 HIGHWAY 180 W STE A
Practice Address - Street 2:
Practice Address - City:MINERAL WELLS
Practice Address - State:TX
Practice Address - Zip Code:76067-8295
Practice Address - Country:US
Practice Address - Phone:940-325-3706
Practice Address - Fax:940-325-6200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-02
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX741838363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty