| Space Center Ipa Pa | |
|
12902 Cloud Dr Santa Fe TX 77510-9345 | |
| (409) 316-1928 | |
| (713) 344-9421 |
| Full Name | Space Center Ipa Pa |
|---|---|
| Speciality | General Practice |
| Location | 12902 Cloud Dr, Santa Fe, Texas |
| Authorized Official Name and Position | Joe E Pouzar (PRESIDENT) |
| Authorized Official Contact | 4093161928 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Space Center Ipa Pa Po Box 525 Santa Fe TX 77510-0525 Ph: (409) 316-1928 | Space Center Ipa Pa 12902 Cloud Dr Santa Fe TX 77510-9345 Ph: (409) 316-1928 |
| NPI Number | 1891900981 |
|---|---|
| Provider Enumeration Date | 05/11/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891900981 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
Texas Professional Healthcare Alliance, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12902 Cloud Dr, Santa Fe, TX 77510 Phone: 409-316-1928 Fax: 713-344-9421 | |
Bruce Mht Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12422 Highway 6, Santa Fe, TX 77510 Phone: 409-316-9298 |