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Organization

YOUR FIRST CLASS MEDICAL CLINIC PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ROSA A FUENTES M.D. (OWNER)
(713) 453-9400
Entity
Organization

Contact information

Practice address
13415 WOODFOREST BLVD, HOUSTON, TX 77015-2922
(713) 453-9400
(210) 541-8841
Mailing address
13415 WOODFOREST BLVD, HOUSTON, TX 77015-2922
(713) 453-9400
(210) 541-8841

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
K1817
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
K1817
LICENSE
TX
Enumeration date
12/28/2010
Last updated
12/28/2010
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