Organization Name: | YOUR FIRST CLASS MEDICAL CLINIC PLLC |
NPI Number: | 1225332661 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROSA A FUENTES (OWNER) |
Mailing Address: | 13415 Woodforest Blvd Houston |
State: | TX US |
Postal Code: | 770152922 |
Phone Number: | 7134539400 |
Fax Number: | 2105418841 |
NPI Enumeration Date: | 12/28/2010 |
NPI Last Update Date: | 12/28/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | K1817 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |