Provider Demographics
NPI:1679292056
Name:HIGGINBOTHAM HEALTHCARE PLLC
Entity Type:Organization
Organization Name:HIGGINBOTHAM HEALTHCARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:HIGGINBOTHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:817-714-8906
Mailing Address - Street 1:3313 PECAN MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-2268
Mailing Address - Country:US
Mailing Address - Phone:817-714-8906
Mailing Address - Fax:
Practice Address - Street 1:3313 PECAN MEADOWS DR
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-2268
Practice Address - Country:US
Practice Address - Phone:817-714-8906
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-26
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty