| Northwest Diagnostic Clinic, Pa | |
|
8845 Six Pines Dr Fl 2 Shenandoah TX 77380-2675 | |
| (832) 232-5500 | |
| (832) 232-5510 |
| Full Name | Northwest Diagnostic Clinic, Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 8845 Six Pines Dr Fl 2, Shenandoah, Texas |
| Authorized Official Name and Position | Stephen D Fillman (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 8322325500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northwest Diagnostic Clinic, Pa 2255 E Mossy Oaks Rd Ste 500 Spring TX 77389-1813 Ph: (281) 440-5300 | Northwest Diagnostic Clinic, Pa 8845 Six Pines Dr Fl 2 Shenandoah TX 77380-2675 Ph: (832) 232-5500 |
| NPI Number | 1942209515 |
|---|---|
| Provider Enumeration Date | 07/18/2005 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942209515 | NPI | - | NPPES |
| 162607901 | Medicaid | TX | |
| 00T359 | Other | TX | BCBS OF TEXAS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (Texas) | Primary |
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