Organization
FAIRMOUNT FAMILY PRACTICE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRISCILLA PIPES RHIT (CREDENTIALING ADMINISTRATION)
(936) 615-4265
Entity
Organization
Contact information
Practice address
3732 FAIRDALE RD, HEMPHILL, TX 75948
(409) 579-2044
(409) 579-2104
Mailing address
3732 FAIRDALE RD, HEMPHILL, TX 75948
(409) 579-2044
(409) 579-2104
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
AP123751
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1922114206
NPI
TX
Enumeration date
06/30/2017
Last updated
07/21/2022
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