Organization
MAVIS FUJII MDPA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN YATES (DIRECTOR, CONTRACTING)
(713) 517-4022
Entity
Organization
Contact information
Practice address
18333 EGRET BAY BLVD STE 650, HOUSTON, TX 77058-6405
(281) 333-9933
Mailing address
3802 VIECREST DR, PEARLAND, TX 77584-5949
(713) 517-4022
Taxonomy
Speciality
Code
Description
License number
State
2084N0008X
Neuromuscular Medicine (Psychiatry & Neurology) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013099399
INDIVIDUAL NPI
—
Enumeration date
11/20/2018
Last updated
11/20/2018
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