Organization
ORANGE FAMILY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICK POMONIS DO (OWNER)
(409) 738-2882
Entity
Organization
Contact information
Practice address
3306 RIDGEMONT DR, ORANGE, TX 77630-4236
(409) 882-0995
(409) 883-4440
Mailing address
PO BOX 669386, DALLAS, TX 75266-9386
(877) 896-6474
(409) 883-4440
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
H0730
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45D0973723
CLIA CERTIFICATE
TX
Enumeration date
03/14/2006
Last updated
05/20/2024
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