Provider Demographics
NPI:1417202565
Name:FAMILY MEDICINE OF ABILENE PA
Entity Type:Organization
Organization Name:FAMILY MEDICINE OF ABILENE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:SCHULTZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:325-480-9280
Mailing Address - Street 1:1309 HICKORY ST
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79601-3509
Mailing Address - Country:US
Mailing Address - Phone:325-480-9280
Mailing Address - Fax:325-400-2007
Practice Address - Street 1:1309 HICKORY ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-3509
Practice Address - Country:US
Practice Address - Phone:325-480-9280
Practice Address - Fax:325-480-9280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-16
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ2313207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty