Organization
PROVIDENCE MISSION MINISTRY LLC
Active
Other names
Providence Family Care
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER NGUYEN (BUSINESS ACCOUNT MANAGER)
(281) 774-8785
Entity
Organization
Contact information
Practice address
21 ALPINE ST, COLDSPRING, TX 77331-8058
(936) 647-2227
(936) 647-2202
Mailing address
PO BOX 1293, NEW CANEY, TX 77357-1293
(281) 774-8785
(832) 543-5006
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
371798501
—
TX
Enumeration date
01/12/2017
Last updated
03/08/2020
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