Southwest Family Clinic Pc | |
3003 S Loop W Ste 555 Houston TX 77054-1378 | |
(713) 433-4536 | |
(713) 433-6708 |
Full Name | Southwest Family Clinic Pc |
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Speciality | Family Medicine |
Location | 3003 S Loop W Ste 555, Houston, Texas |
Authorized Official Name and Position | E. Chinyere Nwanna (PROVIDER) |
Authorized Official Contact | 7134334536 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Southwest Family Clinic Pc 3003 S Loop W Ste 555 Houston TX 77054-1378 Ph: (713) 433-4563 | Southwest Family Clinic Pc 3003 S Loop W Ste 555 Houston TX 77054-1378 Ph: (713) 433-4536 |
NPI Number | 1619285996 |
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Provider Enumeration Date | 09/20/2010 |
Last Update Date | 09/25/2023 |
Medicare PECOS PAC ID | 3870787021 |
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Medicare Enrollment ID | O20101101001279 |
Identifier | Type | State | Issuer |
---|---|---|---|
1619285996 | NPI | - | NPPES |
282911101 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | E. Chinyere Nwanna |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1073746566 PECOS PAC ID: 5890889018 Enrollment ID: I20101101001450 |
Provider Name | Mark E Hennessy |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1194784728 PECOS PAC ID: 5890886832 Enrollment ID: I20110131000943 |
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