Organization
CHAMPIONS SPINE CENTER PA
Active
Parent organization
CHAMPIONS SPINE CENTER PA
Other names
LAKE JACKSON FAMILY PRACTICE PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHAMPIONS SPINE CENTER PA
Authorized official
MR. THOMAS NGUYEN (BILLING MANAGER)
(713) 774-5462
Entity
Organization
Contact information
Practice address
135 OYSTER CREEK DR STE W, LAKE JACKSON, TX 77566-4117
(979) 299-1200
(979) 299-1205
Mailing address
14450 TC JESTER BLVD STE 100, HOUSTON, TX 77014-1332
(713) 774-5462
(713) 774-5478
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
N3996
TX
Other
Enumeration date
08/09/2011
Last updated
08/09/2011
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