Family Medicine At Willow Bend

LBN: Family Medicine At Willow Bend
Family Medicine At Willow Bend is an health care organization with primary practice located at 5944 W Parker Rd Ste 100 , Plano TX 75093-6422. The organization recently has only one registered license in Ambulatory Health Care Facilities / Health Service, which is considered as the primary health care specialty. Family Medicine At Willow Bend can be contacted via phone (972) 608-1868, or through Komenda, Tammy Tickle via phone (972) 608-1868.

Contact Information

Primary practice address
5944 W Parker Rd Ste 100 Plano TX 75093-6422
Phone: (972) 608-1868
Fax: (972) 943-8644
Website:
Map and Directions
Authorized official contact:
Name: Komenda, Tammy Tickle
Phone: (972) 608-1868

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Health Service 261QH0100X H6350 Texas

Profile Details

NPI number 1174726061
LBN Legal business name Family Medicine At Willow Bend
DBA Doing business as
Authorized official Komenda, Tammy Tickle
Entity Organization
Organization subpart 1 No
Enumeration date Jun 7th, 2007
Last updated Aug 12th, 2008 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174726061 NPPES
Texas Other 10018514 AMERIGROUP PROVIDER #
Texas MEDICAID 165802301 AMERIGROUP PROVIDER #
Texas MEDICAID 65802302 AMERIGROUP PROVIDER #

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