| Mychn Silverlake | |
|
9430 Broadway St Ste 120 Pearland TX 77584-8075 | |
| (281) 824-1480 | |
| (281) 220-6407 |
| Full Name | Mychn Silverlake |
|---|---|
| Speciality | Clinic/Center |
| Location | 9430 Broadway St Ste 120, Pearland, Texas |
| Authorized Official Name and Position | Brandy Smith (CREDENTIALING) |
| Authorized Official Contact | 2818241480 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mychn Silverlake 1111 W Adoue St Alvin TX 77511-2718 Ph: (281) 824-1480 | Mychn Silverlake 9430 Broadway St Ste 120 Pearland TX 77584-8075 Ph: (281) 824-1480 |
| NPI Number | 1255087938 |
|---|---|
| Provider Enumeration Date | 02/22/2022 |
| Last Update Date | 02/20/2025 |
| Certification Date | 02/20/2025 |
| Medicare PECOS PAC ID | 6204977127 |
|---|---|
| Medicare Enrollment ID | O20230315002368 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255087938 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | () | Primary |
| 261QM1300X | Clinic/center - Multi-specialty | () | Secondary |
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