Provider Demographics
NPI:1194960633
Name:FAMILY CARE SPECIALISTS
Entity type:Organization
Organization Name:FAMILY CARE SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLARREAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-466-7221
Mailing Address - Street 1:1643 E LOS EBANOS BLVD
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-8541
Mailing Address - Country:US
Mailing Address - Phone:956-495-8658
Mailing Address - Fax:956-548-1198
Practice Address - Street 1:1643 E LOS EBANOS BLVD
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-8541
Practice Address - Country:US
Practice Address - Phone:956-495-8658
Practice Address - Fax:956-548-1198
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAMILY CARE SPECIALISTS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-12-12
Last Update Date:2008-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ9582207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty