Provider Demographics
NPI:1871602060
Name:COPPERFIELD FAMILY MEDICINE, P.A.
Entity type:Organization
Organization Name:COPPERFIELD FAMILY MEDICINE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOTTA
Authorized Official - Middle Name:
Authorized Official - Last Name:HILLERT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-345-4747
Mailing Address - Street 1:7555 CHERRY PARK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-2722
Mailing Address - Country:US
Mailing Address - Phone:281-345-4747
Mailing Address - Fax:281-345-6774
Practice Address - Street 1:7555 CHERRY PARK DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-2722
Practice Address - Country:US
Practice Address - Phone:281-345-4747
Practice Address - Fax:281-345-6774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2009-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00982NMedicare PIN