Organization
SPACE CENTER IPA PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOE E POUZAR MD (PRESIDENT)
(409) 316-1928
Entity
Organization
Contact information
Practice address
12902 CLOUD DR, SANTA FE, TX 77510-9345
(409) 316-1928
(713) 344-9421
Mailing address
PO BOX 525, SANTA FE, TX 77510-0525
(409) 316-1928
(713) 344-9421
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
05/11/2007
Last updated
08/22/2020
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