Provider Demographics
NPI:1730446493
Name:DM FRIENDLY FAMILY HEALTHCARE
Entity type:Organization
Organization Name:DM FRIENDLY FAMILY HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:R
Authorized Official - Last Name:MIKEL
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN, MSN, FNP-C
Authorized Official - Phone:281-935-1384
Mailing Address - Street 1:2301 LAUREL ST
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-2265
Mailing Address - Country:US
Mailing Address - Phone:281-935-1384
Mailing Address - Fax:281-385-8518
Practice Address - Street 1:2301 LAUREL ST
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-2265
Practice Address - Country:US
Practice Address - Phone:281-935-1384
Practice Address - Fax:281-385-8518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-19
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center