| I-10 Family Clinic | |
|
11929 East Fwy Suite D Houston TX 77029-2025 | |
| (713) 637-8665 | |
| Not Available |
| Full Name | I-10 Family Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 11929 East Fwy, Houston, Texas |
| Authorized Official Name and Position | Prentiss Lee Harrison (CEO) |
| Authorized Official Contact | 7136378665 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| I-10 Family Clinic 11929 East Fwy Suite D Houston TX 77029-2025 Ph: (713) 637-8665 | I-10 Family Clinic 11929 East Fwy Suite D Houston TX 77029-2025 Ph: (713) 637-8665 |
| NPI Number | 1386966505 |
|---|---|
| Provider Enumeration Date | 02/16/2010 |
| Last Update Date | 06/28/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386966505 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | M7120 (Texas) | Primary |
| 363A00000X | Physician Assistant | PA00256 (Texas) | Secondary |
| 363A00000X | Physician Assistant | PA00114 (Texas) | Secondary |
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