| NPI | 1639752124 |
|---|---|
| Doing Business As | AVENUE 360 HEALTH AND WELLNESS FANNIN |
| Entity Type | Organization |
| Authorized Contact | TEQUILA HENDERSON Revenue Cycle Director 713-426-0027 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2021-05-03 |
| Last Update Date | 2024-05-01 |