| Timarron Family Medicine Pa | |
|
200 Pecan Crk Southlake TX 76092-6371 | |
| (817) 481-4739 | |
| (817) 481-5198 |
| Full Name | Timarron Family Medicine Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 200 Pecan Crk, Southlake, Texas |
| Authorized Official Name and Position | Michelle Renee Barton (PRACTICE MANAGER) |
| Authorized Official Contact | 8174814739 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Timarron Family Medicine Pa 200 Pecan Crk Southlake TX 76092-6371 Ph: (817) 481-4739 | Timarron Family Medicine Pa 200 Pecan Crk Southlake TX 76092-6371 Ph: (817) 481-4739 |
| NPI Number | 1073727368 |
|---|---|
| Provider Enumeration Date | 05/09/2007 |
| Last Update Date | 09/06/2007 |
| Medicare PECOS PAC ID | 5496736563 |
|---|---|
| Medicare Enrollment ID | O20040525001341 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073727368 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | J4265 (Texas) | Primary |
| Provider Name | Lori Massey King |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891796074 PECOS PAC ID: 8527049600 Enrollment ID: I20101202000173 |
| Provider Name | Christopher Murphy King |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750382461 PECOS PAC ID: 4183605264 Enrollment ID: I20101202000243 |
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