Trophy Club Family Medicine PA
NPI #1922093061 in Trophy Club, Texas
Provider Information
- NPI Number
- 1922093061
- Entity Type
- Organization
- Organization Name
- Trophy Club Family Medicine PA
- Primary Specialty
- Family Medicine
- Enumeration Date
- Sep 14, 2005
- Last Updated
- Oct 31, 2007
Practice Location
- Address
- 301 TROPHY LAKE DR
- Address 2
- #136
- City
- Trophy Club
- State
- Texas
- ZIP Code
- 76262-5238
- Phone
- (817) 430-9111
Authorized Official
- Name
- LAINEY GEE
- Title
- BUSINESS MANAGER
- Phone
- (817) 430-9111
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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