Provider Demographics
NPI:1134148216
Name:MID-CITIES FAMILY CARE, LLP
Entity type:Organization
Organization Name:MID-CITIES FAMILY CARE, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:R
Authorized Official - Last Name:TERRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-494-5000
Mailing Address - Street 1:3024 HIGHWAY 121
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-4037
Mailing Address - Country:US
Mailing Address - Phone:817-494-5000
Mailing Address - Fax:817-494-5001
Practice Address - Street 1:3024 HIGHWAY 121
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-4037
Practice Address - Country:US
Practice Address - Phone:817-494-5000
Practice Address - Fax:817-494-5001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX080544201Medicaid
TX00411NMedicare ID - Type Unspecified