Beulah Family Clinic Professional Limited Liability Company

NPI #1750144150 in Desoto, Texas

Provider Information

NPI Number: 1750144150
Entity Type: Organization
Organization Name: Beulah Family Clinic Professional Limited Liability Company
Primary Specialty: Clinic/Center
Enumeration Date: Jan 30, 2024
Last Updated: Jun 28, 2024

Practice Location

Address: 1534-A N HAMPTON ROAD
Address 2: SUITE 100
City: Desoto
State: Texas
ZIP Code: 75115-0073
Phone: (469) 585-8129

Authorized Official

Name: PATRICK MONEKE
Title: ADMINISTRATOR
Phone: (817) 366-0950

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X	Primary

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