Provider Demographics
NPI:1568175990
Name:LANDMARK FAMILY MEDICAL PLLC
Entity Type:Organization
Organization Name:LANDMARK FAMILY MEDICAL PLLC
Other - Org Name:LANDMARK FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:URISH
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:941-228-1001
Mailing Address - Street 1:108 MCKINNEY ST
Mailing Address - Street 2:
Mailing Address - City:FARMERSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75442-2224
Mailing Address - Country:US
Mailing Address - Phone:469-885-0988
Mailing Address - Fax:469-812-3020
Practice Address - Street 1:108 MCKINNEY ST
Practice Address - Street 2:
Practice Address - City:FARMERSVILLE
Practice Address - State:TX
Practice Address - Zip Code:75442-2224
Practice Address - Country:US
Practice Address - Phone:469-885-0988
Practice Address - Fax:469-812-3020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-30
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty