Organization
HOUSTON PHYSICIANS IPA PLLC
Active
Other names
HOUSTON PHYSICIANS IPA PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LAN NHU BICH PHAN MPH (ADMINISTRATOR)
(818) 399-8996
Entity
Organization
Contact information
Practice address
6 VERANDA, NEWPORT COAST, CA 92657-1632
(818) 399-8996
Mailing address
6 VERANDA, NEWPORT COAST, CA 92657-1632
(818) 399-8996
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1143333600002
TEXAS SECRETARY OF STATE CERTIFICATE OF FORMATION OF PLLC
TX
Enumeration date
11/01/2022
Last updated
11/01/2022
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