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Organization
FAMILY MEDICINE RURAL HEALTH CLINIC, PA
Active
Organization
FAMILY MEDICINE RURAL HEALTH CLINIC, PA
Active
Other names
Family Medicine Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MARK S LANE MD (PRESIDENT)
(512) 556-3621
Entity
Organization
Contact information
Practice address
2401 WALKER PLACE BLVD, COPPERAS COVE, TX 76522-4025
(254) 547-5516
(254) 542-0039
Mailing address
207 W AVENUE E, LAMPASAS, TX 76550-1820
(512) 556-3621
(512) 556-4080
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
261QR1300X
Rural Health Clinic/Center
—
TX
Other
Enumeration date
03/06/2012
Last updated
03/20/2017
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