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Organization
LIFE SPAN CLINIC INC
Active
Organization
LIFE SPAN CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA A. SMED (CEO)
(713) 325-2198
Entity
Organization
Contact information
Practice address
6201 BONHOMME RD, SUITE # 472S, HOUSTON, TX 77036-4385
(713) 325-2198
(713) 325-2968
Mailing address
6201 BONHOMME RD, SUITE # 472S, HOUSTON, TX 77036-4385
(713) 325-2198
(713) 325-2968
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
208D00000X
General Practice Physician
—
—
Other
Enumeration date
06/02/2014
Last updated
06/09/2014
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