Organization
59 MEDICAL CLINIC LLC
Active
Organization
59 MEDICAL CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOLORES T CASTILLO (PRESIDENT)
(713) 691-8400
Entity
Organization
Contact information
Practice address
3500 LITTLE YORK RD, HOUSTON, TX 77093-3658
(713) 691-8400
(713) 691-8402
Mailing address
3500 LITTLE YORK RD, HOUSTON, TX 77093-3658
(713) 691-8400
(713) 691-8402
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
F8052
TX
208D00000X
General Practice Physician
F8052
TX
261Q00000X
Clinic/Center
Primary
F8052
TX
Other
Enumeration date
07/20/2011
Last updated
08/16/2011
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