Family Diagnostic Medical Center, LLP

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

FAMILY DIAGNOSTIC MEDICAL CENTER, LLP

Practice address

1314 N Brazos St
Whitney, TX 76692-2010

Phone

(254) 694-6997

Fax

(254) 694-7007

NPI assigned

Aug 31, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Gerardo Carbajal, MBA

Title

Administrator

Phone

(254) 580-1550

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1283212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308096000000",
    "number": "1447566211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1314 N BRAZOS ST",
            "city": "WHITNEY",
            "state": "TX",
            "postal_code": "766922010",
            "telephone_number": "254-694-6997",
            "fax_number": "254-694-7007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 N BRAZOS ST",
            "city": "WHITNEY",
            "state": "TX",
            "postal_code": "766922010",
            "telephone_number": "254-694-6997",
            "fax_number": "254-694-7007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DIAGNOSTIC MEDICAL CENTER, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-31",
        "last_updated": "2011-06-15",
        "status": "A",
        "authorized_official_last_name": "CARBAJAL",
        "authorized_official_first_name": "GERARDO",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "254-580-1550",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2011; 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.