| Dmrestor Clinic Pllc | |
|
1315 St Joseph Pkwy Ste 1200 Houston TX 77002-8235 | |
| (832) 426-4394 | |
| (713) 239-0142 |
| Full Name | Dmrestor Clinic Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1315 St Joseph Pkwy Ste 1200, Houston, Texas |
| Authorized Official Name and Position | Eric Steven Tait (OWNER) |
| Authorized Official Contact | 8776683311 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dmrestor Clinic Pllc 1315 St Joseph Pkwy Ste 1200 Houston TX 77002-8235 Ph: (832) 426-4394 | Dmrestor Clinic Pllc 1315 St Joseph Pkwy Ste 1200 Houston TX 77002-8235 Ph: (832) 426-4394 |
| NPI Number | 1154038388 |
|---|---|
| Provider Enumeration Date | 10/27/2022 |
| Last Update Date | 11/07/2023 |
| Medicare PECOS PAC ID | 2769856228 |
|---|---|
| Medicare Enrollment ID | O20230323001921 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154038388 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Eric Steven Tait |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952323792 PECOS PAC ID: 7719981513 Enrollment ID: I20060911000301 |
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