Provider Demographics
NPI:1619987252
Name:MINISTERING PHYSICIANS, P.A.
Entity Type:Organization
Organization Name:MINISTERING PHYSICIANS, P.A.
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:512-271-1821
Mailing Address - Street 1:3000 JOE DIMAGGIO BLVD
Mailing Address - Street 2:STE 15
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78665-3922
Mailing Address - Country:US
Mailing Address - Phone:512-246-6170
Mailing Address - Fax:512-246-6174
Practice Address - Street 1:3000 JOE DIMAGGIO BLVD
Practice Address - Street 2:BLDG 400 STE 15
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78665-3922
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:2006-08-08
Last Update Date:2016-06-10
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
TX179415801Medicaid
TX0013NPOtherBLUE CROSS PROV #
TX179415801Medicaid
TX00W364Medicare PIN