Organization
BRAESWOOD VACCINE CLINIC,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HARMINDER S CHANA MD (MEDICAL DIRECTOR)
(832) 251-0500
Entity
Organization
Contact information
Practice address
8622 S BRAESWOOD BLVD, HOUSTON, TX 77031-1301
(832) 251-0500
(832) 251-0503
Mailing address
1940 FOUNTAIN VIEW DR, UNIT 204, HOUSTON, TX 77057-3206
(832) 251-0500
(832) 251-0503
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
G1258
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
126374107
—
TX
Enumeration date
04/02/2009
Last updated
11/09/2009
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