SUPREME MEDICAL CENTER LLC NPI 1023573805

NPI Information

NPI: 1023573805
Provider Name: SUPREME MEDICAL CENTER LLC
Classification: General Practice - 208D00000X
Entity Type: Organization

CLIA Number: 45D2220297

Address:
350 N SAM HOUSTON PKWY E STE B240
HOUSTON, TX
ZIP 77060
Phone: (844) 245-8747
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SUPREME MEDICAL CENTER LLC is a general practice in Houston, TX. SUPREME MEDICAL CENTER LLC NPI is 1023573805. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

350 N SAM HOUSTON PKWY E STE B240
HOUSTON, TX
ZIP 77060-315
Phone: (844) 245-8747

The provider's authorized official is Brittany Green .
The authorized official title is Owner and has the following contact phone number (844) 258-8747.

The CLIA number assigned to this NPI record is 45D2220297 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/5/2019 and was last updated on 4/16/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208D00000X	General Practice				Yes
2	261Q00000X	Clinic/Center				No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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