Organization
BRETSHIRE MEDICAL CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES MICHAEL LAROSE DO (PRESIDENT)
(713) 633-2100
Entity
Organization
Contact information
Practice address
7030 BRETSHIRE ST, HOUSTON, TX 77016
(713) 633-2100
(713) 633-2103
Mailing address
7030 BRETSHIRE ST, HOUSTON, TX 77016
(713) 633-2100
(713) 633-2103
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
D7432
TX
207Q00000X
Family Medicine Physician
Primary
D7470
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
131844603
—
TX
Enumeration date
03/19/2007
Last updated
06/09/2008
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