Provider Demographics
NPI:1932350550
Name:PREVENTATIVE HEALTHCARE INSTITUTE, LLC
Entity Type:Organization
Organization Name:PREVENTATIVE HEALTHCARE INSTITUTE, LLC
Other - Org Name:FAMILY WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:D
Authorized Official - Last Name:HROMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-353-2848
Mailing Address - Street 1:1920 MEDI PARK DR STE 2
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-2111
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:806-353-2848
Practice Address - Street 1:1920 MEDI PARK DR STE 2
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-2111
Practice Address - Country:US
Practice Address - Phone:806-353-2848
Practice Address - Fax:806-353-2848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-01
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK5311207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty