Provider Demographics
NPI:1992165393
Name:MEDI CARE CLINICS PLLC
Entity type:Organization
Organization Name:MEDI CARE CLINICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:BLAINE
Authorized Official - Last Name:HAMBY
Authorized Official - Suffix:
Authorized Official - Credentials:MSN
Authorized Official - Phone:940-442-6455
Mailing Address - Street 1:9557 N BEACH ST
Mailing Address - Street 2:SUITE 121
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-6395
Mailing Address - Country:US
Mailing Address - Phone:940-741-5050
Mailing Address - Fax:940-741-5059
Practice Address - Street 1:2601 SCRIPTURE ST
Practice Address - Street 2:SUITE 102
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-4321
Practice Address - Country:US
Practice Address - Phone:940-442-6455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX728078363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty