| Centerwell Senior Primary Care - Humble | |
|
9688 Fm 1960 Bypass Rd W Humble TX 77338-4040 | |
| (281) 318-2401 | |
| (833) 749-0334 |
| Full Name | Centerwell Senior Primary Care - Humble |
|---|---|
| Speciality | Internal Medicine |
| Location | 9688 Fm 1960 Bypass Rd W, Humble, Texas |
| Authorized Official Name and Position | Angie Martinez (SENIOR CREDENTIALING PROFESSIONAL) |
| Authorized Official Contact | 4074477120 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Centerwell Senior Primary Care - Humble 4700 Millenia Blvd Ste 650 Orlando FL 32839-6013 Ph: (407) 447-7120 | Centerwell Senior Primary Care - Humble 9688 Fm 1960 Bypass Rd W Humble TX 77338-4040 Ph: (281) 318-2401 |
| NPI Number | 1750901781 |
|---|---|
| Provider Enumeration Date | 04/20/2020 |
| Last Update Date | 10/18/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750901781 | NPI | - | NPPES |
| 4165003-01 | Medicaid | TX | |
| 792121 | Other | TX | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
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