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Organization
I-10 FAMILY CLINIC
Active
Organization
I-10 FAMILY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PRENTISS LEE HARRISON (CEO)
(713) 637-8665
Entity
Organization
Contact information
Practice address
11929 EAST FWY, SUITE D, HOUSTON, TX 77029-2025
(713) 637-8665
Mailing address
11929 EAST FWY, SUITE D, HOUSTON, TX 77029-2025
(713) 637-8665
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M7120
TX
363A00000X
Physician Assistant
PA00114
TX
363A00000X
Physician Assistant
PA00256
TX
Other
Enumeration date
02/16/2010
Last updated
06/28/2010
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