# GREAT HOUSTON MEDICAL CLINIC

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

## Provider details

- **NPI number:** 1265802193
- **Authorized official:** JINDONG FAN (ADMINISTRATOR)
- **Authorized official phone:** (832) 877-9656

## Contact information

- **Practice address:** 17510 W GRAND PKWY S STE 410, SUGAR LAND, TX 77479-2649
- **Practice address phone:** (713) 705-2954
- **Practice address fax:** (281) 651-5283
- **Mailing address:** 8306 SEAGULL LN, PEARLAND, TX 77584-7134
- **Mailing address phone:** (832) 877-9656
- **Mailing address fax:** (281) 651-5283

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/05/2015
- **Last updated:** 10/05/2015