Organization
CENTERWELL SENIOR PRIMARY CARE (TX) PA
Active
Parent organization
CENTERWELL SENIOR PRIMARY CARE (TX) PA
Other names
Partners in Primary Care KS, PA, CenterWell Senior Primary Care- Tidwell, Partners in Primary Care-Tidwell, Partners In Primary Care TX, PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTERWELL SENIOR PRIMARY CARE (TX) PA
Authorized official
ANGIE MARTINEZ (SENIOR CREDENTIALING PROFESSIONAL)
(407) 447-7120
Entity
Organization
Contact information
Practice address
9417 MESA DR STE A, HOUSTON, TX 77028-1253
(713) 848-7780
(833) 710-0641
Mailing address
4700 MILLENIA BLVD STE 650, ORLANDO, FL 32839-6013
(407) 447-7120
(407) 770-0661
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
208D00000X
General Practice Physician
—
—
Other
Enumeration date
02/11/2020
Last updated
10/18/2022
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