| Physician Home Patient Management | |
|
4141 Southwest Fwy Suite 510 Houston TX 77027-7313 | |
| (713) 528-7902 | |
| (713) 960-1122 |
| Full Name | Physician Home Patient Management |
|---|---|
| Speciality | Clinic/Center |
| Location | 4141 Southwest Fwy, Houston, Texas |
| Authorized Official Name and Position | Roxanne Citizen Sandel (DIRECTOR OF OPERATION) |
| Authorized Official Contact | 2813007235 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Physician Home Patient Management 12719 Water Oak Dr Missouri City TX 77489-3903 Ph: (713) 528-2097 | Physician Home Patient Management 4141 Southwest Fwy Suite 510 Houston TX 77027-7313 Ph: (713) 528-7902 |
| NPI Number | 1730457946 |
|---|---|
| Provider Enumeration Date | 12/02/2011 |
| Last Update Date | 01/08/2015 |
| Medicare PECOS PAC ID | 8527229558 |
|---|---|
| Medicare Enrollment ID | O20120418000228 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730457946 | NPI | - | NPPES |
| 1396763611 | Other | TX | MEDICAL DIRECTOR |
| 1659395952 | Other | TX | MEDICAL DIRECTOR |
| 1427034271 | Other | TX | MEDICAL DIRECTOR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | F7120 (Texas) | Primary |
| Provider Name | Eli T Anderson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053342634 PECOS PAC ID: 4082603238 Enrollment ID: I20040511001520 |
| Provider Name | Maryam Margaret Qayum |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1497814966 PECOS PAC ID: 0749258119 Enrollment ID: I20040923000044 |
| Provider Name | Ayesha Q Mccoy |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1063672111 PECOS PAC ID: 1759506322 Enrollment ID: I20140716000155 |
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