Provider Demographics
NPI:1558190736
Name:HOMETOWN FAMILY CARE, PLLC
Entity type:Organization
Organization Name:HOMETOWN FAMILY CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:MILLER
Authorized Official - Last Name:JERNIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-202-2597
Mailing Address - Street 1:16203 HIGHWAY 36
Mailing Address - Street 2:
Mailing Address - City:NEEDVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77461-9320
Mailing Address - Country:US
Mailing Address - Phone:346-251-4501
Mailing Address - Fax:346-253-1367
Practice Address - Street 1:16203 HIGHWAY 36
Practice Address - Street 2:
Practice Address - City:NEEDVILLE
Practice Address - State:TX
Practice Address - Zip Code:77461-9320
Practice Address - Country:US
Practice Address - Phone:346-251-4501
Practice Address - Fax:346-253-1367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-29
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care