Provider Demographics
NPI:1861497448
Name:UVALDE FAMILY PRACTICE ASSOC.
Entity Type:Organization
Organization Name:UVALDE FAMILY PRACTICE ASSOC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELMA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-278-4453
Mailing Address - Street 1:1800 GARNER FIELD RD
Mailing Address - Street 2:
Mailing Address - City:UVALDE
Mailing Address - State:TX
Mailing Address - Zip Code:78801-6210
Mailing Address - Country:US
Mailing Address - Phone:830-278-4453
Mailing Address - Fax:830-278-3427
Practice Address - Street 1:1800 GARNER FIELD RD
Practice Address - Street 2:
Practice Address - City:UVALDE
Practice Address - State:TX
Practice Address - Zip Code:78801-6210
Practice Address - Country:US
Practice Address - Phone:830-278-4453
Practice Address - Fax:830-278-3427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-20
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG6787207Q00000X
TXH0376207Q00000X
TX45D0506268291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No291U00000XLaboratoriesClinical Medical LaboratoryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX017801401OtherAMERIGROUP INS.
TX017801401OtherMOLINA INS.
TX126866602OtherSUPERIOR HEALTHPLAN
TX083850001OtherSUPERIOR HEALTHPLAN
TX083850001OtherMOLINA HEALTH INS.
TX083850001OtherAMERIGROUP INS.
TX135092804OtherSUPERIOR HEALTHPLAN
TX017801401OtherSUPERIOR HEALTH