# FAMILY DIAGNOSTIC MEDICAL CENTER, LLP

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

## Provider details

- **NPI number:** 1447566211
- **Authorized official:** MR. GERARDO CARBAJAL MBA (ADMINISTRATOR)
- **Authorized official phone:** (254) 580-1550

## Contact information

- **Practice address:** 1314 N BRAZOS ST, WHITNEY, TX 76692-2010
- **Practice address phone:** (254) 694-6997
- **Practice address fax:** (254) 694-7007
- **Mailing address:** 1314 N BRAZOS ST, WHITNEY, TX 76692-2010
- **Mailing address phone:** (254) 694-6997
- **Mailing address fax:** (254) 694-7007

## Taxonomy

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

## Other

- **Enumeration date:** 08/31/2010
- **Last updated:** 06/15/2011