Family Care Medical Center

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

K8749 Issued in TX

Legal business name

FAMILY CARE MEDICAL CENTER

Practice address

1205 N Josey LN
Carrollton, TX 75006-6145

Phone

(972) 242-2726

Fax

(972) 242-5266

NPI assigned

Aug 6, 2007

Organization subpart

No

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

Authorized official

Name

Guillermo M Fuentes, DONPI 1962599571

Title

President Owner

Phone

(972) 242-2726

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Guillermo Martin Fuentes, D.O.

  • Family Medicine Physician
  • Carrollton, TX
  • NPI 1962599571
  Medicare reassignment NPD Authorized official
• Annie Abraham, FNP

  • Family Nurse Practitioner
  • Carrollton, TX
  • NPI 1275030652
  NPD (past)
• Stachia Aiken

  • Family Nurse Practitioner
  • Carrollton, TX
  • NPI 1366119372

  Single Specialty

  NPD (past)
• Yennier Diaz, FNP-C

  • Family Nurse Practitioner
  • Plano, TX
  • NPI 1891295770
  NPD (past)
• Elischa Brown, FNP

  • Family Nurse Practitioner
  • Shreveport, LA
  • NPI 1184032989
  NPD (past)

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

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200614400000",
    "number": "1356532147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 N JOSEY LN",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750066145",
            "telephone_number": "972-242-2726",
            "fax_number": "972-242-5266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 N JOSEY LN",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750066145",
            "telephone_number": "972-242-2726",
            "fax_number": "972-242-5266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY CARE MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-06",
        "last_updated": "2008-01-18",
        "status": "A",
        "authorized_official_last_name": "FUENTES",
        "authorized_official_first_name": "GUILLERMO",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "972-242-2726",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "TX",
            "license": "K8749",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "147634301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fairway Pediatrics, PLLC
• Shireen Faisal, DNAP
• Shantell Marie Faithful
• Huma Fakhr
• Meghan L Faller, RN
• Family Care Nursing, PLLC
• Family Life Chiropractic, Inc
• Family Medicine Associates of Texas
• Family Radiology of Denton LLC
• Audrey Fan

• Clinic/Center in Carrollton, TX
• Providers in Carrollton, TX by specialty
• Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.