Provider Demographics
NPI:1710970694
Name:FAMILY HEALTHCARE CLINIC, LLC
Entity Type:Organization
Organization Name:FAMILY HEALTHCARE CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:LORENE
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, MSN
Authorized Official - Phone:817-225-0517
Mailing Address - Street 1:700 HUNTERS ROW CT
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-4001
Mailing Address - Country:US
Mailing Address - Phone:817-225-0517
Mailing Address - Fax:817-225-0521
Practice Address - Street 1:700 HUNTERS ROW CT
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-4001
Practice Address - Country:US
Practice Address - Phone:817-225-0517
Practice Address - Fax:817-225-0521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR27870363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty