| Airline Medical Clinic | |
|
11012 Airline Dr Ste A Houston TX 77037-1112 | |
| (281) 820-8955 | |
| (281) 820-5541 |
| Full Name | Airline Medical Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 11012 Airline Dr Ste A, Houston, Texas |
| Authorized Official Name and Position | Jose I Gonzalez (ADMINISTRATOR) |
| Authorized Official Contact | 7134471375 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Airline Medical Clinic 11012 Airline Dr Ste A Houston TX 77037-1112 Ph: (281) 820-8955 | Airline Medical Clinic 11012 Airline Dr Ste A Houston TX 77037-1112 Ph: (281) 820-8955 |
| NPI Number | 1386744142 |
|---|---|
| Provider Enumeration Date | 09/22/2006 |
| Last Update Date | 01/05/2023 |
| Medicare PECOS PAC ID | 4981619640 |
|---|---|
| Medicare Enrollment ID | O20060216000269 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386744142 | NPI | - | NPPES |
| 180218301 | Medicaid | TX | |
| 0076NP | Other | TX | BCBS GROUP |
| 180218302 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 208000000X | Pediatrics | (* (Not Available)) | Secondary |
| Provider Name | Pablo E Amador |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962427849 PECOS PAC ID: 4183618523 Enrollment ID: I20141205001873 |
| Provider Name | Tarina Desai |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821380700 PECOS PAC ID: 6608176169 Enrollment ID: I20151205000042 |
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