# 1ST MEDCARE CLINIC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1962805036
- **Authorized official:** BEN KODAE (PRESIDENT)
- **Authorized official phone:** (832) 877-3380

## Contact information

- **Practice address:** 2306 N ALEXANDER DR, BAYTOWN, TX 77520-3455
- **Practice address phone:** (832) 877-3380
- **Practice address fax:** (281) 428-7247
- **Mailing address:** PO BOX 505, BELLAIRE, TX 77402-0505
- **Mailing address phone:** (832) 877-3380
- **Mailing address fax:** (282) 428-7247

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | — | NULL | — |
| 111N00000X | Chiropractor | — | — | — |
| 132700000X | Dietary Manager | — | NULL | — |
| 132700000X | Dietary Manager | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207XX0005X | Sports Medicine (Orthopaedic Surgery) Physician | — | NULL | — |
| 207XX0005X | Sports Medicine (Orthopaedic Surgery) Physician | — | — | — |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |
| 225700000X | Massage Therapist | — | NULL | — |
| 225700000X | Massage Therapist | — | — | — |

## Other

- **Enumeration date:** 10/03/2014
- **Last updated:** 10/03/2014