| Ideal Care Family Doctor Pllc | |
|
1315 W Grand Pkwy S Ste 104 Katy TX 77494-8290 | |
| (713) 287-0924 | |
| Not Available |
| Full Name | Ideal Care Family Doctor Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 1315 W Grand Pkwy S Ste 104, Katy, Texas |
| Authorized Official Name and Position | Liset Avalos Enriquez (MEDICAL DOCTOR) |
| Authorized Official Contact | 2817526437 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ideal Care Family Doctor Pllc 1315 W Grand Pkwy S Ste 104 Katy TX 77494-8290 Ph: () - | Ideal Care Family Doctor Pllc 1315 W Grand Pkwy S Ste 104 Katy TX 77494-8290 Ph: (713) 287-0924 |
| NPI Number | 1720784135 |
|---|---|
| Provider Enumeration Date | 02/07/2023 |
| Last Update Date | 03/06/2023 |
| Medicare PECOS PAC ID | 4385017979 |
|---|---|
| Medicare Enrollment ID | O20230301002072 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720784135 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Liset Avalos Enriquez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356648588 PECOS PAC ID: 5991178584 Enrollment ID: I20230301002288 |
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