| N. W. Houston Family Practice, P. A. | |
|
11706 Fallbrook Dr Houston TX 77065-3510 | |
| (832) 912-6282 | |
| Not Available |
| Full Name | N. W. Houston Family Practice, P. A. |
|---|---|
| Speciality | Family Medicine |
| Location | 11706 Fallbrook Dr, Houston, Texas |
| Authorized Official Name and Position | Angelina Ibiwari Ayoola (MEDICAL DIRECTOR) |
| Authorized Official Contact | 8329126282 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| N. W. Houston Family Practice, P. A. Po Box 692312 Houston TX 77269-2312 Ph: (832) 912-6282 | N. W. Houston Family Practice, P. A. 11706 Fallbrook Dr Houston TX 77065-3510 Ph: (832) 912-6282 |
| NPI Number | 1588796296 |
|---|---|
| Provider Enumeration Date | 03/09/2007 |
| Last Update Date | 05/24/2011 |
| Medicare PECOS PAC ID | 4486541257 |
|---|---|
| Medicare Enrollment ID | O20040304000584 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588796296 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | K9218 (Texas) | Primary |
| Provider Name | Angelina I Ayoola |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407960792 PECOS PAC ID: 8921995796 Enrollment ID: I20040419000772 |
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