Organization
CENTERWELL SENIOR PRIMARY CARE (TX) PA
Active
Organization
CENTERWELL SENIOR PRIMARY CARE (TX) PA
Active
Parent organization
CENTERWELL SENIOR PRIMARY CARE (TX) PA
Other names
CenterWell Senior Primary Care -Downtown East, Partners In Primary Care TX, PA, Partners In Primary Care- Downtown East
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTERWELL SENIOR PRIMARY CARE (TX) PA
Authorized official
ANGIE MARTINEZ (SENIOR CREDENTIALING PROFESSIONAL)
(407) 447-7120
Entity
Organization
Contact information
Practice address
5104 HARRISBURG BLVD STE 800, HOUSTON, TX 77011-0001
(832) 667-4150
(833) 853-9420
Mailing address
4700 MILLENIA BLVD STE 650, ORLANDO, FL 32839-6013
(407) 447-7120
(407) 770-0661
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
208D00000X
General Practice Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4089997-01
—
TX
01
—
792121
MEDICARE
TX
Enumeration date
02/21/2019
Last updated
10/18/2022
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