# FAMILY PRACTICE OF TEXARKANA PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** TEXARKANA FAMILY PRACTICE PA
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417289380
- **Authorized official:** MRS. GIGI CULBERSON CMC, CMIS (CREDENTIALING MANAGER)
- **Authorized official phone:** (903) 793-0122

## Contact information

- **Practice address:** 1408 COLLEGE DR, TEXARKANA, TX 75503-3534
- **Practice address phone:** (903) 794-0515
- **Practice address fax:** (903) 793-8000
- **Mailing address:** 1408 COLLEGE DR, TEXARKANA, TX 75503-3534
- **Mailing address phone:** (903) 794-0515
- **Mailing address fax:** (903) 793-8000

## Taxonomy

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

## Other

- **Enumeration date:** 02/03/2010
- **Last updated:** 02/03/2010