Provider Demographics
NPI:1750921441
Name:JR FAMILY HEALTHCARE, PLLC
Entity type:Organization
Organization Name:JR FAMILY HEALTHCARE, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER/FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:BACHYNSKY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, FNP-C, APRN
Authorized Official - Phone:832-964-6436
Mailing Address - Street 1:6505 FM 1280 E
Mailing Address - Street 2:
Mailing Address - City:LOVELADY
Mailing Address - State:TX
Mailing Address - Zip Code:75851-3688
Mailing Address - Country:US
Mailing Address - Phone:936-544-7223
Mailing Address - Fax:936-544-8083
Practice Address - Street 1:1501 E LOOP 304 STE 50
Practice Address - Street 2:
Practice Address - City:CROCKETT
Practice Address - State:TX
Practice Address - Zip Code:75835-3417
Practice Address - Country:US
Practice Address - Phone:832-964-6436
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-09
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX408787601Medicaid