Organization Name: | VICTORY HEALTH CENTER LLC |
NPI Number: | 1326483819 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ESTHER KEKKI (SOLE OWNER) |
Mailing Address: | 13711 Westheimer Rd Ste B3 West Oaks Place Shopping Center By Eld Houston |
State: | TX US |
Postal Code: | 770775369 |
Phone Number: | 2814973224 |
Fax Number: | 2814973225 |
NPI Enumeration Date: | 05/09/2013 |
NPI Last Update Date: | 09/03/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 807741 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |