Active NPI
Your Family Doctor, PLLC
- Family Medicine Physician
- Montgomery, TX
National Provider Identifier
1275049637
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- H0285
- Legal business name
- YOUR FAMILY DOCTOR, PLLC
- Practice address
- 123 Blue Heron Dr Ste 101
Montgomery, TX 77316-3192 - Phone
- (936) 582-6000
- Fax
- (936) 448-6404
- NPI assigned
- Dec 21, 2017
- Last updated
- Dec 21, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Andrew J Davis, MD
- Title
- Medical Doctor
- Phone
- (936) 582-6000
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | H0285 | TX | Primary |
Addresses
Primary practice location
123 Blue Heron Dr Ste 101
Montgomery, TX 77316-3192
Mailing address
123 Blue Heron Dr Ste 101
Montgomery, TX 77316-3192
Phone (936) 582-6000
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00390413 | Other | TX | RAILROAD |
| 1932214608 | Other | TX | INDVIDUAL NPI |
| 0074PA | Other | TX | BCBS OF TX |
National Provider Directory
National Provider Directory- Tax ID family
- Your Family Doctor PLLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Family Medicine Physician
- Montgomery, TX
- NPI 1255847448
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1513814400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1513814400000",
"number": "1275049637",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "123 BLUE HERON DR STE 101",
"city": "MONTGOMERY",
"state": "TX",
"postal_code": "773163192",
"telephone_number": "936-582-6000",
"fax_number": "936-448-6404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "123 BLUE HERON DR STE 101",
"city": "MONTGOMERY",
"state": "TX",
"postal_code": "773163192",
"telephone_number": "936-582-6000",
"fax_number": "936-448-6404"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "YOUR FAMILY DOCTOR, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2017-12-21",
"last_updated": "2017-12-21",
"status": "A",
"authorized_official_last_name": "DAVIS",
"authorized_official_first_name": "ANDREW",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "MEDICAL DOCTOR",
"authorized_official_telephone_number": "936-582-6000",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "H0285",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD",
"identifier": "P00390413",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDVIDUAL NPI",
"identifier": "1932214608",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF TX",
"identifier": "0074PA",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Montgomery, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.