Provider Demographics
NPI:1770072761
Name:TPC FAMILY MEDICINE & HOME VISITS, PLLC
Entity type:Organization
Organization Name:TPC FAMILY MEDICINE & HOME VISITS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTOYA
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:210-240-4854
Mailing Address - Street 1:2603 N ARKANSAS AVE STE C
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78043-2202
Mailing Address - Country:US
Mailing Address - Phone:956-568-5394
Mailing Address - Fax:956-568-3294
Practice Address - Street 1:2603 N ARKANSAS AVE STE C
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78043-2202
Practice Address - Country:US
Practice Address - Phone:956-568-5394
Practice Address - Fax:956-568-3294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-04
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherTAX-ID