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Organization
MIDTOWN CLINICAL ASSOC, PA
Active
Organization
MIDTOWN CLINICAL ASSOC, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ENDIA NICHELLE WALLS M.D. (OWNER)
(713) 748-4662
Entity
Organization
Contact information
Practice address
4405 GRIGGS RD, HOUSTON, TX 77021-2815
(713) 748-4662
Mailing address
PO BOX 300958, HOUSTON, TX 77230-0958
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
163278801
—
TX
Enumeration date
04/22/2007
Last updated
11/02/2022
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