| Avenue 360 Health And Wellness Fannin | |
|
2920 Fannin St Houston TX 77002 | |
| (713) 341-3790 | |
| Not Available |
| Full Name | Avenue 360 Health And Wellness Fannin |
|---|---|
| Speciality | Clinic/Center |
| Location | 2920 Fannin St, Houston, Texas |
| Authorized Official Name and Position | Tequila Henderson (REVENUE CYCLE DIRECTOR) |
| Authorized Official Contact | 7134260027 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Avenue 360 Health And Wellness Fannin 2150 W 18th St Ste 300 Houston TX 77008-1289 Ph: (713) 426-0027 | Avenue 360 Health And Wellness Fannin 2920 Fannin St Houston TX 77002 Ph: (713) 341-3790 |
| NPI Number | 1639752124 |
|---|---|
| Provider Enumeration Date | 05/03/2021 |
| Last Update Date | 10/24/2024 |
| Medicare PECOS PAC ID | 6608977095 |
|---|---|
| Medicare Enrollment ID | O20210930000962 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639752124 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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