| 290 Mangum Healthcare Llc | |
|
5005 W 34th St Suite 102c Houston TX 77092-4200 | |
| (713) 682-2212 | |
| (713) 682-9997 |
| Full Name | 290 Mangum Healthcare Llc |
|---|---|
| Speciality | Family Medicine - Adult Medicine |
| Location | 5005 W 34th St, Houston, Texas |
| Authorized Official Name and Position | Tabare D Tabar (MANAGER) |
| Authorized Official Contact | 7136822212 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 290 Mangum Healthcare Llc 5005 W 34th St Suite 102c Houston TX 77092-4200 Ph: (713) 682-2212 | 290 Mangum Healthcare Llc 5005 W 34th St Suite 102c Houston TX 77092-4200 Ph: (713) 682-2212 |
| NPI Number | 1164726956 |
|---|---|
| Provider Enumeration Date | 01/07/2011 |
| Last Update Date | 01/07/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164726956 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | PA01537 (Texas) | Primary |
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