| Hispano -american Family Clinic Llc | |
|
12779 Jones Rd Ste 109 Houston TX 77070-4687 | |
| (346) 206-3963 | |
| (346) 206-3983 |
| Full Name | Hispano -american Family Clinic Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 12779 Jones Rd Ste 109, Houston, Texas |
| Authorized Official Name and Position | Lizandra Pereira Corzo (FNP-C) |
| Authorized Official Contact | 3462063963 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hispano -american Family Clinic Llc 12779 Jones Rd Ste 109 Houston TX 77070-4687 Ph: (346) 206-3963 | Hispano -american Family Clinic Llc 12779 Jones Rd Ste 109 Houston TX 77070-4687 Ph: (346) 206-3963 |
| NPI Number | 1700350535 |
|---|---|
| Provider Enumeration Date | 01/15/2019 |
| Last Update Date | 12/17/2019 |
| Medicare PECOS PAC ID | 6800220617 |
|---|---|
| Medicare Enrollment ID | O20200103001694 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700350535 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| Provider Name | Lizandra Rosales |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265904866 PECOS PAC ID: 0446684153 Enrollment ID: I20200103001738 |
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