Provider Demographics
NPI:1558878249
Name:COMPLETE CARE FAMILY MEDICAL CLINIC PLLC
Entity Type:Organization
Organization Name:COMPLETE CARE FAMILY MEDICAL CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:KINDE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-703-6421
Mailing Address - Street 1:2304 NICOLE DR
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78574-9716
Mailing Address - Country:US
Mailing Address - Phone:975-703-6421
Mailing Address - Fax:956-585-3363
Practice Address - Street 1:2408 N CONWAY AVE
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78574-2347
Practice Address - Country:US
Practice Address - Phone:956-585-3397
Practice Address - Fax:956-585-3363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-04
Last Update Date:2018-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6984207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty