FOUNTAIN OF LIFE LLC NPI 1710223573

NPI Information

NPI: 1710223573
Provider Name: FOUNTAIN OF LIFE LLC

Doing Business As: MEDCUBA CLINIC

Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
1820 W 43RD ST
HOUSTON, TX
ZIP 77018
Phone: (832) 548-1701
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FOUNTAIN OF LIFE LLC is a primary care clinic center in Houston, TX. FOUNTAIN OF LIFE LLC NPI is 1710223573. The provider is registered as an organization entity type.
The provider Is Doing Business As Medcuba Clinic.

The provider's business location address is:

1820 W 43RD ST
HOUSTON, TX
ZIP 77018-006
Phone: (832) 548-1701
Fax: (713) 393-7466

The provider's authorized official is Cynthia Diane Goodman .
The authorized official title is Dr and has the following contact phone number (832) 548-1701.

The enumeration date for this NPI number is 12/26/2012 and was last updated on 7/30/2013.

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	261QP2300X	Clinic/Center	Primary Care			Yes

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: 5/5/2024

NPI Synchronization or Removal

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