Provider Demographics
NPI:1306479613
Name:FAMECO-TEXAS LLC
Entity type:Organization
Organization Name:FAMECO-TEXAS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:T
Authorized Official - Last Name:HAUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-630-6944
Mailing Address - Street 1:2803 E VETERANS MEMORIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76543-4326
Mailing Address - Country:US
Mailing Address - Phone:254-630-6944
Mailing Address - Fax:
Practice Address - Street 1:2803 E VETERANS MEMORIAL BLVD
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76543-4326
Practice Address - Country:US
Practice Address - Phone:254-630-6944
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAMECO-TEXAS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-02-14
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Single Specialty