Organization
1960 FAMILY PRACTICE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANA BORJA (CREDENTIALING DEPARTMENT)
(281) 453-7224
Entity
Organization
Contact information
Practice address
8850 SIX PINES DRIVE, SUITE 190, THE WOODLANDS, TX 77380
(281) 586-3888
(281) 440-2020
Mailing address
PO BOX 4356, DEPARTMENT 667, HOUSTON, TX 77210-4356
(281) 586-3888
(281) 440-2020
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
TX
207R00000X
Internal Medicine Physician
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
195426501
—
TX
Enumeration date
03/26/2007
Last updated
09/11/2013
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