| Katy Centro Medico Hispano | |
|
2351 Fry Rd Katy TX 77449-6219 | |
| (281) 717-8134 | |
| (281) 717-8140 |
| Full Name | Katy Centro Medico Hispano |
|---|---|
| Speciality | Clinic/Center |
| Location | 2351 Fry Rd, Katy, Texas |
| Authorized Official Name and Position | Lisbeth Luis (MANAGER) |
| Authorized Official Contact | 2817178134 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Katy Centro Medico Hispano 2351 Fry Rd Katy TX 77449-6219 Ph: (281) 717-8134 | Katy Centro Medico Hispano 2351 Fry Rd Katy TX 77449-6219 Ph: (281) 717-8134 |
| NPI Number | 1457076291 |
|---|---|
| Provider Enumeration Date | 10/04/2022 |
| Last Update Date | 10/06/2022 |
| Certification Date | 10/06/2022 |
| Medicare PECOS PAC ID | 0648707174 |
|---|---|
| Medicare Enrollment ID | O20241223002363 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457076291 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (NU) | Primary |
| Provider Name | Yadira Castro Gonzalez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427450493 PECOS PAC ID: 9234593211 Enrollment ID: I20230908002770 |
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