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29310 Prairie Rose Ct Katy TX 77494-7384 | |
| (832) 937-5596 | |
| (832) 937-5596 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 29310 Prairie Rose Ct, Katy, Texas |
| Authorized Official Name and Position | Norbe Luis Basulto Basulto (DIRECTOR) |
| Authorized Official Contact | 7136601603 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
29310 Prairie Rose Ct Katy TX 77494-7384 Ph: (832) 937-5596 | 29310 Prairie Rose Ct Katy TX 77494-7384 Ph: (832) 937-5596 |
| NPI Number | 1871290825 |
|---|---|
| Provider Enumeration Date | 02/09/2023 |
| Last Update Date | 11/12/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871290825 | NPI | - | NPPES |
| 1861628505 | Other | TX | BLUE CROSS AND BLUE SHIELD |
| 1861628505 | Other | TX | MOLINA |
| 1861628505 | Other | TX | OSCAR |
| 1861628505 | Other | TX | UNITED HEALTH CARE |
| 1861628505 | Medicaid | TX | |
| 1861628505 | Other | TX | COMMUNITY HEALTH CHOICE |
| 1861628505 | Other | TX | CIGNA |
| 1861628505 | Other | TX | AMBETTER |
| 1861628505 | Other | TX | AETNA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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