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Organization
PREMIER FAMILY CARE I, INC.
Active
Organization
PREMIER FAMILY CARE I, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEAH BEJIL (CREDENTIALING MANAGER)
(432) 686-6605
Entity
Organization
Contact information
Practice address
1900 W. WALL, SUITE A, MIDLAND, TX 79701-6534
(432) 498-2900
(432) 498-2990
Mailing address
2501 W. ILLINOIS, SUITE C, MIDLAND, TX 79701-6433
(432) 686-6600
(432) 682-2284
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018061401
MEDICAID EPSDT#
TX
Enumeration date
07/30/2007
Last updated
11/14/2012
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