Provider Demographics
NPI:1104447937
Name:CENTENARY FAMILY & URGENT CARE
Entity type:Organization
Organization Name:CENTENARY FAMILY & URGENT CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:MRS
Authorized Official - First Name:INITA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:FNP,PMHNP-BC
Authorized Official - Phone:469-949-8900
Mailing Address - Street 1:211 W PLEASANT RUN RD STE 102
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:TX
Mailing Address - Zip Code:75146-1585
Mailing Address - Country:US
Mailing Address - Phone:469-949-8900
Mailing Address - Fax:214-339-2784
Practice Address - Street 1:211 W PLEASANT RUN RD STE 102
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:TX
Practice Address - Zip Code:75146-1585
Practice Address - Country:US
Practice Address - Phone:469-949-8900
Practice Address - Fax:214-339-2784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-04
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty