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Organization
MEDICAL PARKWAY FAMILY PRACTICE,LLP
Active
Organization
MEDICAL PARKWAY FAMILY PRACTICE,LLP
Active
Other names
BRAZOS FAMILY MEDICINE
Organization subpart
No
Provider details
NPI number
Authorized official
LISA JOHNSON KIRK D.O. (PHYSICIAN/OWNER)
(254) 776-8008
Entity
Organization
Contact information
Practice address
318 RICHLAND WEST CIR, SUITE A, WACO, TX 76712-7919
(254) 776-8008
(254) 776-6892
Mailing address
318 RICHLAND WEST CIR, SUITE A, WACO, TX 76712-7919
(254) 776-8008
(254) 776-6892
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
151015803
—
TX
Enumeration date
11/09/2006
Last updated
04/22/2009
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