Active NPI
Doctors for the Family P a
- Family Medicine Physician
- Lake Jackson, TX
National Provider Identifier
1962536367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1S3090901 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 DirectoryLocations
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.