Organization
PREMIER FAMILY CARE I, INC
Active
Other names
PREMIER PHYSICIANS
Organization subpart
No
Provider details
NPI number
Authorized official
CANDACE WYNNE (CREDENTIALING)
(432) 686-6605
Entity
Organization
Contact information
Practice address
4214 ANDREWS HWY STE 240, MIDLAND, TX 79703-4817
(432) 686-6605
(432) 682-2284
Mailing address
PO BOX 5426, BELFAST, ME 04915-5400
(432) 686-6600
(432) 682-2284
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207N00000X
Dermatology Physician
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RI0200X
Infectious Disease Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
208000000X
Pediatrics Physician
—
—
2080A0000X
Pediatric Adolescent Medicine Physician
—
—
208200000X
Plastic Surgery Physician
—
—
2084N0400X
Neurology Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
261QR0404X
Cardiac Rehabilitation Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0008AH
BCBS
TX
01
—
018061401
MEDICAID EPSDT
TX
05
—
079837301
—
TX
Enumeration date
10/17/2005
Last updated
06/13/2025
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