| Santa Clara Family Clinic | |
|
5616 Lawndale St Suite A-203 Houston TX 77023-3840 | |
| (713) 923-2273 | |
| (713) 923-2276 |
| Full Name | Santa Clara Family Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 5616 Lawndale St, Houston, Texas |
| Authorized Official Name and Position | Jason T Urtis (MANAGER) |
| Authorized Official Contact | 7139232273 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Santa Clara Family Clinic 2837 Clinton Dr Houston TX 77020-8401 Ph: (713) 923-2273 | Santa Clara Family Clinic 5616 Lawndale St Suite A-203 Houston TX 77023-3840 Ph: (713) 923-2273 |
| NPI Number | 1275716110 |
|---|---|
| Provider Enumeration Date | 12/13/2007 |
| Last Update Date | 07/02/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275716110 | NPI | - | NPPES |
| 192241102 | Medicaid | TX | |
| 0011RB | Other | TX | BCBS |
| 192241101 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 208000000X | Pediatrics | (* (Not Available)) | Secondary |
| 363A00000X | Physician Assistant | (* (Not Available)) | Secondary |
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