# YOUR FIRST CLASS MEDICAL CLINIC PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225332661
- **Authorized official:** DR. ROSA A FUENTES M.D. (OWNER)
- **Authorized official phone:** (713) 453-9400

## Contact information

- **Practice address:** 13415 WOODFOREST BLVD, HOUSTON, TX 77015-2922
- **Practice address phone:** (713) 453-9400
- **Practice address fax:** (210) 541-8841
- **Mailing address:** 13415 WOODFOREST BLVD, HOUSTON, TX 77015-2922
- **Mailing address phone:** (713) 453-9400
- **Mailing address fax:** (210) 541-8841

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | K1817 | TX | Yes |

## Other

- **Enumeration date:** 12/28/2010
- **Last updated:** 12/28/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | K1817 | LICENSE | TX |