Organization
WOODFAIR FAMILY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENNETTE BERGERON ADMINSTRATOR (OWNER)
(713) 774-0024
Entity
Organization
Contact information
Practice address
9896 BISSONNET ST STE 375, HOUSTON, TX 77036-8154
(713) 774-0024
(713) 774-0024
Mailing address
9896 BISSONNET #375, 9896 BISSONNET #375, HOUSTON, TX 77036-8154
(713) 774-0024
(713) 774-0028
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
01/18/2012
Last updated
01/18/2012
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