St. Johns Physician Associates, P.a. | |
3139 W Holcombe Blvd #615 Houston TX 77025-1505 | |
(713) 988-8860 | |
(713) 988-8861 |
Full Name | St. Johns Physician Associates, P.a. |
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Speciality | Clinic/Center |
Location | 3139 W Holcombe Blvd, Houston, Texas |
Authorized Official Name and Position | Cheng Samuel Chen (MD) |
Authorized Official Contact | 7139888860 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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St. Johns Physician Associates, P.a. Po Box 981095 Houston TX 77098-8095 Ph: (713) 988-8860 | St. Johns Physician Associates, P.a. 3139 W Holcombe Blvd #615 Houston TX 77025-1505 Ph: (713) 988-8860 |
NPI Number | 1558485789 |
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Provider Enumeration Date | 03/16/2007 |
Last Update Date | 05/13/2008 |
Medicare PECOS PAC ID | 1951202167 |
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Medicare Enrollment ID | O20040120000183 |
Identifier | Type | State | Issuer |
---|---|---|---|
1558485789 | NPI | - | NPPES |
154400901 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | K3125 (Texas) | Primary |
Provider Name | Cheng Chen |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1396803474 PECOS PAC ID: 9739080946 Enrollment ID: I20100910000727 |
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