Provider Demographics
NPI:1679690812
Name:FAMILY WELLNESS CENTER, PA
Entity Type:Organization
Organization Name:FAMILY WELLNESS CENTER, PA
Other - Org Name:FAMILY WELLNESS CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HORIS
Authorized Official - Middle Name:T
Authorized Official - Last Name:STEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:830-693-3621
Mailing Address - Street 1:2300 HWY 281N
Mailing Address - Street 2:
Mailing Address - City:MARBLE FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:78654
Mailing Address - Country:US
Mailing Address - Phone:830-693-3621
Mailing Address - Fax:830-693-7487
Practice Address - Street 1:2300 HWY 281N
Practice Address - Street 2:
Practice Address - City:MARBLE FALLS
Practice Address - State:TX
Practice Address - Zip Code:78654
Practice Address - Country:US
Practice Address - Phone:830-693-3621
Practice Address - Fax:830-693-7487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty