Provider Demographics
NPI:1831251271
Name:NORTH HILLS FAMILY PRACTICE, PA
Entity type:Organization
Organization Name:NORTH HILLS FAMILY PRACTICE, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:SUSAN
Authorized Official - Last Name:GAUWAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-284-6912
Mailing Address - Street 1:4351 BOOTH CALLOWAY RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-7378
Mailing Address - Country:US
Mailing Address - Phone:817-284-1165
Mailing Address - Fax:817-284-4990
Practice Address - Street 1:4351 BOOTH CALLOWAY RD
Practice Address - Street 2:SUITE 101
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-7378
Practice Address - Country:US
Practice Address - Phone:817-284-1165
Practice Address - Fax:817-284-4990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH8646OtherMEDICAL LICENSE- DR FULLER
TXF1559OtherMEDICAL LICENSE-DR GABRIEL
TXK1233OtherMEDICAL LICENSE-DR LAMBERT
TXL8368OtherMEDICAL LICENSE-DR MARTIN