| Pine Forrest Functional Medicine | |
|
150 Pine Forest Dr Ste 701 Woodlands TX 77384-5317 | |
| (972) 743-5136 | |
| Not Available |
| Full Name | Pine Forrest Functional Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 150 Pine Forest Dr Ste 701, Woodlands, Texas |
| Authorized Official Name and Position | Thu Anh Hoang (OWNER) |
| Authorized Official Contact | 9727435136 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pine Forrest Functional Medicine 20111 Ironharp Dr Spring TX 77379-1975 Ph: (972) 743-5136 | Pine Forrest Functional Medicine 150 Pine Forest Dr Ste 701 Woodlands TX 77384-5317 Ph: (972) 743-5136 |
| NPI Number | 1154915205 |
|---|---|
| Provider Enumeration Date | 03/01/2021 |
| Last Update Date | 03/01/2021 |
| Medicare PECOS PAC ID | 5395153472 |
|---|---|
| Medicare Enrollment ID | O20210412000388 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154915205 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Thu A Hoang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801821699 PECOS PAC ID: 0244256634 Enrollment ID: I20051014000397 |
| Provider Name | Minni Malhotra |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528257508 PECOS PAC ID: 5698849206 Enrollment ID: I20111214000663 |