Organization
CENTERWELL SENIOR PRIMARY CARE (TX) PA
Active
Parent organization
CENTERWELL SENIOR PRIMARY CARE (TX) PA
Other names
CenterWell Senior Primary Care-Little York
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
388 W LITTLE YORK RD, HOUSTON, TX 77076-1303
(346) 207-3170
(877) 872-7884
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
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Enumeration date
04/26/2021
Last updated
10/18/2022
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