Provider Demographics
NPI:1750304846
Name:FAMILY HEALTH CENTER LLP
Entity Type:Organization
Organization Name:FAMILY HEALTH CENTER LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:AIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOZA
Authorized Official - Suffix:
Authorized Official - Credentials:CRHCP, CMOM, CMC
Authorized Official - Phone:956-487-5621
Mailing Address - Street 1:2768 PHARMACY RD
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78582-6201
Mailing Address - Country:US
Mailing Address - Phone:956-487-5621
Mailing Address - Fax:956-487-5862
Practice Address - Street 1:2768 PHARMACY RD
Practice Address - Street 2:
Practice Address - City:RIO GRANDE CITY
Practice Address - State:TX
Practice Address - Zip Code:78582-6201
Practice Address - Country:US
Practice Address - Phone:956-487-5621
Practice Address - Fax:956-487-5862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207Q00000X
TX261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX126933404Medicaid
TX00TS24Medicare PIN
TX126933404Medicaid