# CENTRUM MEDICAL HOLDINGS OF TEXAS, LLC

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

## Provider details

- **NPI number:** 1942976360
- **Authorized official:** GRACIELA VANESSA VICTORERO (COO)
- **Authorized official phone:** (305) 266-2929

## Contact information

- **Practice address:** 1463 S MASON RD, KATY, TX 77450-4568
- **Practice address phone:** (305) 266-2929
- **Practice address fax:** (786) 558-0242
- **Mailing address:** 5730 SW 74TH ST STE 200, SOUTH MIAMI, FL 33143-5300
- **Mailing address phone:** (305) 266-2929
- **Mailing address fax:** (786) 558-0242

## Taxonomy

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

## Other

- **Enumeration date:** 08/17/2021
- **Last updated:** 08/17/2021