Provider Demographics
NPI:1447617741
Name:PILOT POINT FAMILY PRACTICE MANAGEMENT INC.
Entity Type:Organization
Organization Name:PILOT POINT FAMILY PRACTICE MANAGEMENT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATT
Authorized Official - Middle Name:
Authorized Official - Last Name:BERESFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-686-2254
Mailing Address - Street 1:1246 SOUTH HIGHWAY 377
Mailing Address - Street 2:
Mailing Address - City:PILOT POINT
Mailing Address - State:TX
Mailing Address - Zip Code:76258
Mailing Address - Country:US
Mailing Address - Phone:940-686-2254
Mailing Address - Fax:
Practice Address - Street 1:1246 S HIGHWAY 377
Practice Address - Street 2:
Practice Address - City:PILOT POINT
Practice Address - State:TX
Practice Address - Zip Code:76258-4353
Practice Address - Country:US
Practice Address - Phone:940-686-2254
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-19
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty