| Doc On The Bay Associated Enterprises Incorporated | |
|
15055 East Fwy Ste C10 Channelview TX 77530-4142 | |
| (281) 452-3547 | |
| Not Available |
| Full Name | Doc On The Bay Associated Enterprises Incorporated |
|---|---|
| Speciality | Internal Medicine |
| Location | 15055 East Fwy Ste C10, Channelview, Texas |
| Authorized Official Name and Position | Laurie Killam (OFFICE MANAGER) |
| Authorized Official Contact | 2814523547 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Doc On The Bay Associated Enterprises Incorporated 15055 East Fwy Ste C10 Channelview TX 77530-4142 Ph: (281) 452-3547 | Doc On The Bay Associated Enterprises Incorporated 15055 East Fwy Ste C10 Channelview TX 77530-4142 Ph: (281) 452-3547 |
| NPI Number | 1285763268 |
|---|---|
| Provider Enumeration Date | 03/05/2007 |
| Last Update Date | 10/31/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285763268 | NPI | - | NPPES |
| 11525501 | Medicaid | TX | |
| 111525501 | Medicaid | TX | |
| 111525504 | Medicaid | TX | |
| 193614801 | Medicaid | TX | |
| 00630V | Other | TX | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | H5715 (Texas) | Primary |
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