Organization Active NPI

Doctors for the Family P a

  • Family Medicine Physician
  • Lake Jackson, TX
National Provider Identifier
1962536367
Registry record updated Dec 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DOCTORS FOR THE FAMILY P A
Practice address
215 Oak Dr S Ste I
Lake Jackson, TX 77566-5618
Phone
(979) 297-5400
Fax
(979) 297-5552
NPI assigned
Mar 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2010

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

Authorized official

Name
Mrs. Georgia Cherry
Title
Office Manager
Phone
(979) 297-5400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

215 Oak Dr S Ste I
Lake Jackson, TX 77566-5618

Mailing address

215 Oak Dr S Ste I
Lake Jackson, TX 77566-5618
Phone (979) 297-5400

Other identifiers 1

IdentifierTypeStateIssuer
1S3090901MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110812000415 TX Part B Supplier - Clinic/Group Practice 6901075720 Receives reassigned benefits from 2 practitioners
Practice locations: Lake Jackson, TX

National Provider Directory

National Provider Directory

Locations

215 Oak Dr S
Ste I
Lake Jackson, TX 77566
Phone (713) 970-1170

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293408000000",
    "number": "1962536367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 OAK DR S STE I",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665618",
            "telephone_number": "979-297-5400",
            "fax_number": "979-297-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 OAK DR S STE I",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665618",
            "telephone_number": "979-297-5400",
            "fax_number": "979-297-5552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCTORS FOR THE FAMILY P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2010-12-27",
        "status": "A",
        "authorized_official_last_name": "CHERRY",
        "authorized_official_first_name": "GEORGIA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "979-297-5400",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1S3090901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Jackson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.