Provider Demographics
NPI:1912086190
Name:FAMILY CARE PLUS CLINIC, PA
Entity Type:Organization
Organization Name:FAMILY CARE PLUS CLINIC, PA
Other - Org Name:FAMILY CARE PLUS REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:NAGHAVI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:281-646-2273
Mailing Address - Street 1:3919 FRY RD
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-6731
Mailing Address - Country:US
Mailing Address - Phone:281-646-2273
Mailing Address - Fax:281-646-9511
Practice Address - Street 1:3919 FRY RD
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449
Practice Address - Country:US
Practice Address - Phone:281-646-2273
Practice Address - Fax:281-646-9511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX166631502Medicaid
TX166631503Medicaid
OH0421076Medicaid
TX166631501Medicaid
OH0274149Medicaid
OH0382952Medicaid