WEATHERFORD FAMILY PRACTICE MEDICAL CENTER PLLC (NPI# 1528204567) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528204567 |
| Entity Type | Organization |
| Organization Name | WEATHERFORD FAMILY PRACTICE MEDICAL CENTER PLLC |
| Practice Address |
3739 Legacy Weatherford OK 73096-9746 |
| Practice Telephone | 5807722400 |
| Practice Fax Number | 5807722408 |
| Mailing Telephone | 5807722400 |
| Mailing Fax Number | 5807722408 |
| Enumeration Date | 2008-12-22 |
| Last Update Date | 2011-01-24 |
| Authorized Official Name | DR. TAMALA ROCHELLE MALLETT MOORE (OWNER/MEDICAL DOCTOR) |
| Authorized Official Telephone | 5807722400 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 26755 | OK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | RAIL ROAD MEDICARE PTAN | P00691960 | 01 |
| OK | 200224110A | 05 | |
| OK | OKLAHOMA STATE MEDICAL LICENSE | 26755 | 01 |
| OK | BNDD | 37994 | 01 |
| OK | MEDICARE PTAN | OKB5382 | 01 |
| Street Address |
3739 LEGACY |
| City | WEATHERFORD |
| State | OK |
| Zip Code | 73096-9746 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689062705 | Weatherford Hospital Authority | Otolaryngology | 3739 Legacy, Weatherford, OK 73096-9746 | 2014-12-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316433170 | Weatherford Hospital Authority | Clinic/Center | 1315 N Washington, Weatherford, OK 73096 | 2018-07-05 |
| 1174030530 | Lacey Bailey | Case Manager/Care Coordinator | 101 E University Dr Apt B2, Weatherford, OK 73096 | 2018-01-08 |
| 1972962066 | Shayli Hill | Physical Therapist | 3730 Legacy Dr, Weatherford, OK 73096 | 2016-02-17 |
| 1396144622 | Xpress Wellness LLC | Family Medicine | 1303 N Washington, Weatherford, OK 73096 | 2014-08-22 |
| 1881942654 | Weatherford Dental Care Pllc | Dentist | 1325 N. Washington Street, Weatherford, OK 73096 | 2012-08-27 |
| 1326352204 | Weatherford Hospital Authority | General Acute Care Hospital | 3727 Legacy, Weatherford, OK 73096 | 2010-08-03 |
| 1316148505 | Janet Vega | Case Manager/Care Coordinator | 1413 Kase St Apt. 1, Weatherford, OK 73096 | 2007-05-29 |
| 1326259797 | Amy Michelle Estes IIi | Case Manager/Care Coordinator | 90 North 31st., Clinton, OK 73096 | 2007-05-25 |
| 1427260256 | Paul C. Tisdal, O.d., P.C. | Optometrist | 1545 N. Washington Ave, Weatherford, OK 73096 | 2007-05-04 |
| 1386786663 | William W Uraneck | Dentist | 617 E Tom Stafford, Weatherford, OK 73096 | 2007-02-13 |
| Find all providers in zip 73096 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275027385 | Star Family Medicine Pllc | Family Medicine | 933 Hilltop Dr Ste 100, Weatherford, TX 76086 | 2018-06-21 |
| 1396144622 | Xpress Wellness LLC | Family Medicine | 1303 N Washington, Weatherford, OK 73096 | 2014-08-22 |
| 1144588401 | Adam Khadbai | Family Medicine | 933 Hilltop Dr, Suite 100, Weatherford, TX 76086-8807 | 2012-04-24 |
| 1629354154 | Kimberly Lynn Strickland | Family Medicine | 925 Santa Fe Dr Ste 107, Weatherford, TX 76086-5867 | 2011-10-28 |
| 1851681456 | Sarah Ogbedei Ashitey | Family Medicine | 2035 Fort Worth Hwy Ste 100, Weatherford, TX 76086-4783 | 2011-04-15 |
| 1609027622 | Tamala Rochelle Mallett Moore | Family Medicine | 3739 Legacy St, Weatherford, OK 73096-9746 | 2008-10-08 |
| 1083894414 | Oklahoma West Physicians Group | Family Medicine | 213 N Illinois St, Weatherford, OK 73096-5437 | 2007-11-14 |
| 1578743993 | Oklahoma West Physicians Group | Family Medicine | 215 N Illinois St, Weatherford, OK 73096-5437 | 2007-11-14 |
| 1184813800 | J Steven Welch Do Pa | Family Medicine | 100 Rooster Cogburn Ct, Weatherford, TX 76088-7228 | 2007-10-18 |
| 1386840643 | Danica A Jordan | Family Medicine | 2005 Fort Worth Hwy Ste 200, Weatherford, TX 76086-4781 | 2007-06-25 |
| Find all providers in WEATHERFORD | ||||
| City | WEATHERFORD |
| Zip Code | 73096 |
Please comment or provide details below to improve the information on WEATHERFORD FAMILY PRACTICE MEDICAL CENTER PLLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.