| Organization Name: | AGGIE FAMILY DOCTOR, PA |
| NPI Number: | 1124320973 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KAREN V SMITH (GENERAL PARTNER) |
| Mailing Address: | 4375 Booth Calloway Rd Ste 208 North Richland Hills |
| State: | TX US |
| Postal Code: | 761808362 |
| Phone Number: | 8178468328 |
| Fax Number: | 8172513214 |
| NPI Enumeration Date: | 11/30/2010 |
| NPI Last Update Date: | 11/30/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | M2820 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |