Organization
HOUSTON PRIMARY CARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DINAKARA B SHETTY MD (OWNER)
(478) 328-0806
Entity
Organization
Contact information
Practice address
1719 RUSSELL PKWY, BLDG. 700, WARNER ROBINS, GA 31088-5763
(478) 328-0806
(478) 328-1393
Mailing address
1719 RUSSELL PKWY STE 700, WARNER ROBINS, GA 31088-5765
(478) 328-8984
(478) 328-1393
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
042431
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000720948L
—
GA
Enumeration date
08/11/2006
Last updated
05/12/2015
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