| Organization Name: | FAMILY MEDICINE RURAL HEALTH CLINIC PA |
| NPI Number: | 1699731257 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARK S LANE (PHYSICIAN) |
| Mailing Address: | 187 Pr 4060 Lampasas |
| State: | TX US |
| Postal Code: | 765504071 |
| Phone Number: | 5125563621 |
| Fax Number: | 5125566594 |
| NPI Enumeration Date: | 04/24/2006 |
| NPI Last Update Date: | 07/03/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |