| Mychn Technology Drive | |
|
4005 Technology Rd Ste 1190 Angleton TX 77515-2557 | |
| (281) 824-1480 | |
| (281) 220-6407 |
| Full Name | Mychn Technology Drive |
|---|---|
| Speciality | Clinic/Center |
| Location | 4005 Technology Rd Ste 1190, Angleton, Texas |
| Authorized Official Name and Position | Brandy Smith (CREDENTIALING COORDINATOR II) |
| Authorized Official Contact | 2818241480 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mychn Technology Drive 1612 Callaway Dr Alvin TX 77511-3743 Ph: (281) 824-1480 | Mychn Technology Drive 4005 Technology Rd Ste 1190 Angleton TX 77515-2557 Ph: (281) 824-1480 |
| NPI Number | 1679258941 |
|---|---|
| Provider Enumeration Date | 06/15/2023 |
| Last Update Date | 03/26/2024 |
| Medicare PECOS PAC ID | 6204977127 |
|---|---|
| Medicare Enrollment ID | O20240401001810 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679258941 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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