Organization
PROFESSIONAL MANAGEMENT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BONIFACE GBALAZEH MD (MANAGER)
(832) 203-5096
Entity
Organization
Contact information
Practice address
8449 W BELLFORT ST STE 330, HOUSTON, TX 77071-2247
(832) 203-5096
Mailing address
8449 W BELLFORT ST, HOUSTON, TX 77071-2245
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
09/21/2021
Last updated
09/21/2021
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