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Organization

CENTERWELL SENIOR PRIMARY CARE (TX) PA

Active
Parent organization
CENTERWELL SENIOR PRIMARY CARE (TX) PA
Other names
Partners in Primary Care KS, PA, Partners In Primary Care TX, PA, Partners in Primary Care-Gulfgate, CenterWell Senior Primary Care -Gulfgate, Partners in Primary Care TX PA
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
545 GULFGATE CENTER MALL, HOUSTON, TX 77087-3023
(281) 846-7209
(833) 845-2872
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
4035966-01
TX
Enumeration date
02/13/2019
Last updated
10/18/2022
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