# FOREST FAMILY CLINIC, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245853811
- **Authorized official:** VICTORIA RODRIGUEZ (OFFICE MANAGER)
- **Authorized official phone:** (469) 804-7929

## Contact information

- **Practice address:** 9550 FOREST LN STE 606, DALLAS, TX 75243-6176
- **Practice address phone:** (469) 804-7929
- **Practice address fax:** (469) 804-7930
- **Mailing address:** 9550 FOREST LN STE 606, DALLAS, TX 75243-5905
- **Mailing address phone:** (469) 804-7929
- **Mailing address fax:** (469) 804-7930

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/18/2020
- **Last updated:** 02/19/2021