Organization
FAMILY HEALTHCARE AFFILIATES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRYSTAL URBAN (OFFICE MANAGER)
(936) 760-4454
Entity
Organization
Contact information
Practice address
800 RIVERWOOD CT, SUITE 105, CONROE, TX 77304-2890
(936) 760-4454
(936) 760-4415
Mailing address
800 RIVERWOOD CT, SUITE 105, CONROE, TX 77304-2890
(936) 760-4454
(936) 760-4415
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0088HZ
BCBS
TX
05
—
157678701
—
TX
Enumeration date
05/24/2006
Last updated
07/19/2010
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