Lac Anh.,pa | |
8208 Gulf Fwy Houston TX 77017-4530 | |
(832) 820-6160 | |
(832) 810-6162 |
Full Name | Lac Anh.,pa |
---|---|
Speciality | Internal Medicine |
Location | 8208 Gulf Fwy, Houston, Texas |
Authorized Official Name and Position | Hoang-anh Lac Phan (MANAGING MEMBER) |
Authorized Official Contact | 7134377114 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Lac Anh.,pa 4906 Ivory Meadows Ln Houston TX 77084-3991 Ph: (713) 437-7114 | Lac Anh.,pa 8208 Gulf Fwy Houston TX 77017-4530 Ph: (832) 820-6160 |
NPI Number | 1508326000 |
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Provider Enumeration Date | 03/21/2019 |
Last Update Date | 10/28/2022 |
Medicare PECOS PAC ID | 9739422114 |
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Medicare Enrollment ID | O20210826000905 |
Identifier | Type | State | Issuer |
---|---|---|---|
1508326000 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Hoang-anh L Phan |
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Provider Type | Practitioner - Hospitalist |
Provider Identifiers | NPI Number: 1407020035 PECOS PAC ID: 2466690094 Enrollment ID: I20141105000114 |
Provider Name | Brandi Morales |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1548841299 PECOS PAC ID: 0244635696 Enrollment ID: I20210823002116 |
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