Provider Demographics
NPI:1679127393
Name:FAMILY FIRST EXPRESS CARE PLLC
Entity type:Organization
Organization Name:FAMILY FIRST EXPRESS CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP REV CYCLE SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:B
Authorized Official - Last Name:SAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-214-1031
Mailing Address - Street 1:10319 JEFFERSON HWY
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-2730
Mailing Address - Country:US
Mailing Address - Phone:225-214-9352
Mailing Address - Fax:225-214-9349
Practice Address - Street 1:1295 S HIGHWAY 183 STE 101
Practice Address - Street 2:
Practice Address - City:LEANDER
Practice Address - State:TX
Practice Address - Zip Code:78641-4557
Practice Address - Country:US
Practice Address - Phone:225-214-9352
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-31
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care