Organization
PRIMEAGE HEALTH SEVICES , INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OLALEKAN ADEMOLA AGBOLUAJE (ADMINISTRATOR)
(281) 385-9800
Entity
Organization
Contact information
Practice address
6250 WESTPARK DR STE 207, HOUSTON, TX 77057-7322
(281) 385-9800
Mailing address
6250 WESTPARK DR STE 207, HOUSTON, TX 77057-7322
(281) 385-9800
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
012279
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
012279
STATE LICENSE
TX
Enumeration date
10/08/2010
Last updated
10/08/2010
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