Provider Demographics
NPI:1184764276
Name:FAMILY FIRST HEALTHCARE
Entity type:Organization
Organization Name:FAMILY FIRST HEALTHCARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADM
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:PATE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-369-0744
Mailing Address - Street 1:4700 W ELDORADO PKWY
Mailing Address - Street 2:SUITE 210
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-5239
Mailing Address - Country:US
Mailing Address - Phone:972-369-0744
Mailing Address - Fax:972-369-0644
Practice Address - Street 1:4700 W ELDORADO PKWY
Practice Address - Street 2:SUITE 210
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-5239
Practice Address - Country:US
Practice Address - Phone:972-369-0744
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GREENVILLE HEALTHCARE ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-07
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX273121363LF0000X
TXE4513207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX133516809Medicaid
TX80166325OtherRR MEDICARE
TXDA2786OtherRR MEDICARE
TX8J1200OtherBCBS
TX163200202Medicaid
TX00332VOtherMEDICARE GROUP
TX0087JYOtherBCBS
TX133516809Medicaid