Provider Demographics
NPI:1265626550
Name:BUFFINGTON FAMILY MEDICINE PLLC
Entity type:Organization
Organization Name:BUFFINGTON FAMILY MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BUFFINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-431-9199
Mailing Address - Street 1:121 QUEST CT
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-3748
Mailing Address - Country:US
Mailing Address - Phone:817-431-9199
Mailing Address - Fax:833-973-3672
Practice Address - Street 1:121 QUEST CT
Practice Address - Street 2:
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248-3748
Practice Address - Country:US
Practice Address - Phone:817-431-9199
Practice Address - Fax:833-973-3672
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-30
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTEMP207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00Y449Medicare PIN