Provider Demographics
NPI:1942277082
Name:OAKS FAMILY PRACTICE, P.A.
Entity Type:Organization
Organization Name:OAKS FAMILY PRACTICE, P.A.
Other - Org Name:OAKS MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GARTH
Authorized Official - Middle Name:C
Authorized Official - Last Name:DENYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-367-1414
Mailing Address - Street 1:25410 INTERSTATE 45 NORTH
Mailing Address - Street 2:#100
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386
Mailing Address - Country:US
Mailing Address - Phone:281-367-1414
Mailing Address - Fax:281-363-5668
Practice Address - Street 1:25410 INTERSTATE 45 N
Practice Address - Street 2:#100
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-1351
Practice Address - Country:US
Practice Address - Phone:281-367-1414
Practice Address - Fax:281-363-5668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-08
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG0690207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6326010001Medicare NSC