| NPI | 1821454539 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHEBA PAPPACHAN Owner 281-786-4359 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: TX AP123576) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: TX AP123576) |
| 261QH0100X Clinic/Center Health Service (Licence: TX AP123576) | |
| 261QM1300X Clinic/Center Multi-Specialty (Licence: TX AP123576) | |
| 305S00000X Point of Service (Licence: TX AP123576) | |
| Enumeration Date | 2016-01-11 |
| Last Update Date | 2017-11-16 |