290 MANGUM HEALTHCARE LLC NPI 1164726956

NPI Information

NPI: 1164726956
Provider Name: 290 MANGUM HEALTHCARE LLC
Classification: Family Medicine - 207QA0505X
Entity Type: Organization

Specialization: Adult Medicine

Address:
5005 W 34TH ST
SUITE 102C
HOUSTON, TX
ZIP 77092
Phone: (713) 682-2212
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290 MANGUM HEALTHCARE LLC is an adult medicine family medicine in Houston, TX. The provider is the National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code. 290 MANGUM HEALTHCARE LLC NPI is 1164726956. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

5005 W 34TH ST
SUITE 102C
HOUSTON, TX
ZIP 77092-200
Phone: (713) 682-2212
Fax: (713) 682-9997

The provider's authorized official is Tabare D Tabar .
The authorized official title is Manager and has the following contact phone number (713) 682-2212.

The enumeration date for this NPI number is 1/7/2011 and was last updated on 1/7/2011.

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	207QA0505X	Family Medicine	Adult Medicine	PA01537	TEXAS	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: 4/28/2024

NPI Synchronization or Removal

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