NPIMap

Organization Active NPI

Premier Family Care I, Inc.

  • Pediatrics Physician
  • Midland, TX
National Provider Identifier
1124218847
Registry record updated Nov 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PREMIER FAMILY CARE I, INC.
Practice address
1900 W. Wall
Suite a
Midland, TX 79701-6534
Phone
(432) 498-2900
Fax
(432) 498-2990
NPI assigned
Jul 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Leah Bejil
Title
Credentialing Manager
Phone
(432) 686-6605

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

1900 W. Wall
Suite a
Midland, TX 79701-6534

Mailing address

2501 W. Illinois
Suite C
Midland, TX 79701-6433
Phone (432) 686-6600

Other identifiers 1

IdentifierTypeStateIssuer
018061401OtherTXMEDICAID EPSDT#

National Provider Directory

National Provider Directory
Tax ID family
Premier Family Care 1 I3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352851200000",
    "number": "1124218847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 W. ILLINOIS",
            "address_2": "SUITE C",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797016433",
            "telephone_number": "432-686-6600",
            "fax_number": "432-682-2284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 W. WALL",
            "address_2": "SUITE A",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797016534",
            "telephone_number": "432-498-2900",
            "fax_number": "432-498-2990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER FAMILY CARE I, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-30",
        "last_updated": "2012-11-14",
        "status": "A",
        "authorized_official_last_name": "BEJIL",
        "authorized_official_first_name": "LEAH",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "432-686-6605"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID EPSDT#",
            "identifier": "018061401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.