| Northwest Medical Group | |
|
1919 North Loop W Ste 218 Houston TX 77008-1374 | |
| (713) 862-5797 | |
| (713) 862-0166 |
| Full Name | Northwest Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 1919 North Loop W, Houston, Texas |
| Authorized Official Name and Position | Van Quang Tran (OWNER) |
| Authorized Official Contact | 7138625797 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northwest Medical Group 1919 North Loop W Ste 218 Houston TX 77008-1374 Ph: (713) 862-5797 | Northwest Medical Group 1919 North Loop W Ste 218 Houston TX 77008-1374 Ph: (713) 862-5797 |
| NPI Number | 1396786711 |
|---|---|
| Provider Enumeration Date | 06/09/2006 |
| Last Update Date | 12/16/2009 |
| Medicare PECOS PAC ID | 2860399540 |
|---|---|
| Medicare Enrollment ID | O20031219000084 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396786711 | NPI | - | NPPES |
| 1712309 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | L3505 (Texas) | Primary |
| Provider Name | Van Q Tran |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194753665 PECOS PAC ID: 9931006616 Enrollment ID: I20031219000106 |
| Provider Name | Sally Thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538197009 PECOS PAC ID: 1759288434 Enrollment ID: I20031219000117 |
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