Provider Demographics
NPI:1508840497
Name:FAMILY HEALTH CARE
Entity Type:Organization
Organization Name:FAMILY HEALTH CARE
Other - Org Name:THE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:PATRICE
Authorized Official - Last Name:CAPAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN,CNS-BC
Authorized Official - Phone:940-381-2313
Mailing Address - Street 1:3537 S I-35 E
Mailing Address - Street 2:SUITE 210
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-6800
Mailing Address - Country:US
Mailing Address - Phone:940-381-2313
Mailing Address - Fax:940-381-5249
Practice Address - Street 1:3537 S I-35 E
Practice Address - Street 2:SUITE 210
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-6800
Practice Address - Country:US
Practice Address - Phone:940-381-2313
Practice Address - Fax:940-381-5249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-04
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX119620604Medicaid
TX119620604Medicaid