| 1960 Family Practice Pa | |
|
837 Cypress Creek Pkwy Suite 105 Houston TX 77090-3423 | |
| (281) 586-3888 | |
| (281) 440-2020 |
| Full Name | 1960 Family Practice Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 837 Cypress Creek Pkwy, Houston, Texas |
| Authorized Official Name and Position | Ana Borja (CREDENTIALING DEPARTMENT) |
| Authorized Official Contact | 2814537017 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 1960 Family Practice Pa Po Box 4356 Department 667 Houston TX 77210-4356 Ph: (281) 586-3888 | 1960 Family Practice Pa 837 Cypress Creek Pkwy Suite 105 Houston TX 77090-3423 Ph: (281) 586-3888 |
| NPI Number | 1760438840 |
|---|---|
| Provider Enumeration Date | 05/26/2006 |
| Last Update Date | 08/14/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760438840 | NPI | - | NPPES |
| C16759 | Other | TX | MEDICARE RAILROAD |
| 080982401 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
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