| Chowdury Tawfiq Mbr | |
|
5252 Hollister St Ste 116 Houston TX 77040-6210 | |
| (210) 990-9417 | |
| Not Available |
| Full Name | Chowdury Tawfiq Mbr |
|---|---|
| Speciality | Family Medicine |
| Location | 5252 Hollister St Ste 116, Houston, Texas |
| Authorized Official Name and Position | Chowdhury Tawfiq (PRESIDENT & CFO) |
| Authorized Official Contact | 2109909417 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chowdury Tawfiq Mbr 5252 Hollister St Ste 116 Houston TX 77040-6210 Ph: () - | Chowdury Tawfiq Mbr 5252 Hollister St Ste 116 Houston TX 77040-6210 Ph: (210) 990-9417 |
| NPI Number | 1396425641 |
|---|---|
| Provider Enumeration Date | 07/21/2023 |
| Last Update Date | 09/23/2024 |
| Medicare PECOS PAC ID | 5799149340 |
|---|---|
| Medicare Enrollment ID | O20230914002465 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396425641 | NPI | - | NPPES |
| 481924501 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Malini A Kumar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801866165 PECOS PAC ID: 0840205001 Enrollment ID: I20060209000592 |
| Provider Name | Ravikanth Reddy R Yalamuri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568791010 PECOS PAC ID: 4486802956 Enrollment ID: I20120907000585 |
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