| Doctors Clinic Houston | |
|
14770 Memorial Dr. Houston TX 77079-5252 | |
| (713) 330-1530 | |
| (713) 330-1535 |
| Full Name | Doctors Clinic Houston |
|---|---|
| Speciality | Family Medicine |
| Location | 14770 Memorial Dr., Houston, Texas |
| Authorized Official Name and Position | Leslie Allison (MEDICAL DIRECTOR) |
| Authorized Official Contact | 2819778372 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Doctors Clinic Houston 14770 Memorial # 200 Houston TX 77079-5252 Ph: (281) 493-5535 | Doctors Clinic Houston 14770 Memorial Dr. Houston TX 77079-5252 Ph: (713) 330-1530 |
| NPI Number | 1861446304 |
|---|---|
| Provider Enumeration Date | 05/20/2006 |
| Last Update Date | 01/18/2021 |
| Medicare PECOS PAC ID | 0345237582 |
|---|---|
| Medicare Enrollment ID | O20040428001465 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861446304 | NPI | - | NPPES |
| AMERIGROUP | Other | TX | 10001202 |
| 080591306 | Medicaid | TX | |
| TMHP THSTEPS | Other | TX | 080591302 |
| 00438N | Other | TX | BLUE CROSS BLUE SHIELD |
| 080591301 | Medicaid | TX | |
| 080591305 | Medicaid | TX | |
| 080591307 | Medicaid | TX | |
| 00438N | Other | TX | BC/BS |
| MEDICARE RAIL ROAD | Other | TX | CG5146 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
| Provider Name | Leslie J Allison |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265405534 PECOS PAC ID: 4587650767 Enrollment ID: I20040422001289 |
| Provider Name | Federico Valderrama Bazan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851408496 PECOS PAC ID: 5991763609 Enrollment ID: I20041228000858 |
| Provider Name | Louis E Varela |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720002561 PECOS PAC ID: 7517910235 Enrollment ID: I20050222001013 |
| Provider Name | Viviane B Nguyen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972630424 PECOS PAC ID: 8022109917 Enrollment ID: I20070807000409 |
| Provider Name | Sheikh Ejaz Ahmed |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1457435745 PECOS PAC ID: 4789853011 Enrollment ID: I20120206000834 |
| Provider Name | Emile Fares |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902891302 PECOS PAC ID: 1850553041 Enrollment ID: I20120504000268 |
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