FORT DAVIS FAMILY PRACTICE PA NPI 1578757720

NPI Information

FORT DAVIS FAMILY PRACTICE, PA is a family medicine in Fort Davis, TX. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. FORT DAVIS FAMILY PRACTICE, PA NPI is 1578757720. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1 MEMORIAL SQUARE
BOX 792
FORT DAVIS, TX
ZIP 79734-008
Phone: (432) 426-3217
Fax: (432) 426-3084

The provider's authorized official is James D Luecke .
The authorized official title is Owner/physician and has the following contact phone number (432) 426-3217.

The CLIA number assigned to this NPI record is 45D0508883 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/30/2007 and was last updated on 4/30/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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