Provider Demographics
NPI:1467616185
Name:MINISTERING PHYSICIANS PA
Entity Type:Organization
Organization Name:MINISTERING PHYSICIANS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:F
Authorized Official - Last Name:HAMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-341-0589
Mailing Address - Street 1:1404 LAKE BLUFF COVE
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-5606
Mailing Address - Country:US
Mailing Address - Phone:512-246-6170
Mailing Address - Fax:512-246-6174
Practice Address - Street 1:1404 LAKE BLUFF COVE
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-5606
Practice Address - Country:US
Practice Address - Phone:512-246-6170
Practice Address - Fax:512-246-6174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-11
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ3658207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00W354Medicare PIN