Organization
290 MANGUM HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TABARE D TABAR P A (MANAGER)
(713) 682-2212
Entity
Organization
Contact information
Practice address
5005 W 34TH ST, SUITE 102C, HOUSTON, TX 77092-4200
(713) 682-2212
(713) 682-9997
Mailing address
5005 W 34TH ST, SUITE 102C, HOUSTON, TX 77092-4200
(713) 682-2212
(713) 682-9997
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
PA01537
TX
Other
Enumeration date
01/07/2011
Last updated
01/07/2011
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