| First Family Care, Pllc | |
|
1212 N Highway 377 Ste 119 Roanoke TX 76262-6916 | |
| (682) 831-1591 | |
| Not Available |
| Full Name | First Family Care, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 1212 N Highway 377 Ste 119, Roanoke, Texas |
| Authorized Official Name and Position | Prakash Bhakta (OWNER) |
| Authorized Official Contact | 6828311591 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| First Family Care, Pllc 1212 N Highway 377 Ste 119 Roanoke TX 76262-6916 Ph: (682) 831-1591 | First Family Care, Pllc 1212 N Highway 377 Ste 119 Roanoke TX 76262-6916 Ph: (682) 831-1591 |
| NPI Number | 1154666758 |
|---|---|
| Provider Enumeration Date | 12/07/2012 |
| Last Update Date | 06/10/2013 |
| Medicare PECOS PAC ID | 3577701085 |
|---|---|
| Medicare Enrollment ID | O20130522000598 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154666758 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Aminidhan D Thakkar |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1629058169 PECOS PAC ID: 6103955992 Enrollment ID: I20100604000235 |
| Provider Name | Juanita M Martinez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093003105 PECOS PAC ID: 7214108620 Enrollment ID: I20110915000291 |
| Provider Name | Ranjit K Dhelaria |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386891315 PECOS PAC ID: 1456539915 Enrollment ID: I20160614002276 |
| Provider Name | Jay P Bhakta |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1225574155 PECOS PAC ID: 4789968249 Enrollment ID: I20170228001748 |
| Provider Name | Jordan M Walsh |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1043790918 PECOS PAC ID: 8527304658 Enrollment ID: I20190110003216 |
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