| Family Tree Health Clinic P A | |
|
2911 S Shore Blvd Suite 190 League City TX 77573-3922 | |
| (281) 538-8188 | |
| (281) 538-8189 |
| Full Name | Family Tree Health Clinic P A |
|---|---|
| Speciality | Family Medicine |
| Location | 2911 S Shore Blvd, League City, Texas |
| Authorized Official Name and Position | Alvaro Francisco Zamora (PHYSICIAN) |
| Authorized Official Contact | 2815388188 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Tree Health Clinic P A 2911 S Shore Blvd Suite 190 League City TX 77573-3922 Ph: (281) 538-8188 | Family Tree Health Clinic P A 2911 S Shore Blvd Suite 190 League City TX 77573-3922 Ph: (281) 538-8188 |
| NPI Number | 1205907987 |
|---|---|
| Provider Enumeration Date | 11/13/2006 |
| Last Update Date | 02/25/2014 |
| Medicare PECOS PAC ID | 1658349659 |
|---|---|
| Medicare Enrollment ID | O20040917000766 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205907987 | NPI | - | NPPES |
| 0042LW | Other | TX | BLUE CROSS BLUE SHIELD |
| 177836701 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MDTXJ9936 (Texas) | Primary |
| Provider Name | Alvaro F Zamora |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285736900 PECOS PAC ID: 2567439730 Enrollment ID: I20040916000186 |
| Provider Name | Krislyn Boswell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255899399 PECOS PAC ID: 7517397540 Enrollment ID: I20200415001709 |
| Provider Name | Jisha Mathew |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205478724 PECOS PAC ID: 6709288723 Enrollment ID: I20230905003655 |
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