Breckenridge Family Clinic PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G8349 Issued in TX

Legal business name

BRECKENRIDGE FAMILY CLINIC PA

Practice address

103 South Hartford Street
Breckenridge, TX 76424

Phone

(254) 559-3363

Fax

(254) 559-1252

NPI assigned

Sep 21, 2006

Last updated

Dec 12, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

William Elmo Prater, MDNPI 1700956539

Title

MD President

Phone

(254) 559-3363

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• William Elmo Prater, M.D.

  • Family Medicine Physician
  • Breckenridge, TX
  • NPI 1700956539
  Authorized official Same address or phone

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197417600000",
    "number": "1780782672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 SOUTH HARTFORD STREET",
            "city": "BRECKENRIDGE",
            "state": "TX",
            "postal_code": "76424",
            "telephone_number": "254-559-3363",
            "fax_number": "254-559-1252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 SOUTH HARTFORD STREET",
            "city": "BRECKENRIDGE",
            "state": "TX",
            "postal_code": "76424",
            "telephone_number": "254-559-3363",
            "fax_number": "254-559-1252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRECKENRIDGE FAMILY CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2007-12-12",
        "status": "A",
        "authorized_official_last_name": "PRATER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "ELMO",
        "authorized_official_title_or_position": "MD PRESIDENT",
        "authorized_official_telephone_number": "254-559-3363",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "G8349",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "82J127",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ramsie Rai Bradford, PHARMD
• Breath E-Z Health Care
• Breck Home Care, Inc.
• Breck Sleep Lab, Inc
• Breckenridge Dental PLLC
• Breckenridge Isd
• Lisa Anne Brown, RN
• Shawnda Hennesay Camp, D.C.
• Jenifer Lynn Campbell, MPT
• Childress County Hospital District (Villa Haven Health and Rehabililitation Center)

• Family Medicine Physician in Breckenridge, TX
• Providers in Breckenridge, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2007; 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.