| Kingwood Direct Md Llc | |
|
24 N Main St Kingwood TX 77339-3709 | |
| (281) 570-6758 | |
| (832) 777-6282 |
| Full Name | Kingwood Direct Md Llc |
|---|---|
| Speciality | Family Medicine - Sports Medicine |
| Location | 24 N Main St, Kingwood, Texas |
| Authorized Official Name and Position | Shaun Weaver (OWNER) |
| Authorized Official Contact | 8324455641 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kingwood Direct Md Llc 24 N Main St Kingwood TX 77339-3709 Ph: (281) 570-6758 | Kingwood Direct Md Llc 24 N Main St Kingwood TX 77339-3709 Ph: (281) 570-6758 |
| NPI Number | 1487121943 |
|---|---|
| Provider Enumeration Date | 11/01/2018 |
| Last Update Date | 11/01/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487121943 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | (* (Not Available)) | Primary |
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