| Family Practice Tx | |
|
1208 W Henderson St Ste C Cleburne TX 76033-8731 | |
| (682) 317-1537 | |
| (682) 317-1553 |
| Full Name | Family Practice Tx |
|---|---|
| Speciality | Clinic/Center |
| Location | 1208 W Henderson St Ste C, Cleburne, Texas |
| Authorized Official Name and Position | Brian Nelson (MD/OWNER) |
| Authorized Official Contact | 6823171537 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Practice Tx Po Box 936 Cleburne TX 76033-0936 Ph: (682) 317-1500 | Family Practice Tx 1208 W Henderson St Ste C Cleburne TX 76033-8731 Ph: (682) 317-1537 |
| NPI Number | 1629630249 |
|---|---|
| Provider Enumeration Date | 07/03/2019 |
| Last Update Date | 11/06/2019 |
| Medicare PECOS PAC ID | 6800221110 |
|---|---|
| Medicare Enrollment ID | O20200115000148 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629630249 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Brian S Nelson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255499943 PECOS PAC ID: 4284778127 Enrollment ID: I20100216000781 |
| Provider Name | Foad A Farahmand |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972823169 PECOS PAC ID: 0042469447 Enrollment ID: I20140522001715 |
| Provider Name | Kilea Lanay Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013447101 PECOS PAC ID: 5799038774 Enrollment ID: I20181020000059 |
| Provider Name | Francesca Luppert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538600390 PECOS PAC ID: 8224315528 Enrollment ID: I20210624003550 |
| Provider Name | Lucas L Lopez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912503160 PECOS PAC ID: 4789082603 Enrollment ID: I20211007001300 |
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