Organization
SUNNYSIDE MEDICAL
Active
Other names
Sunnyside Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RONELL WILLIAMS JR. (CONTRACT ADMINISTRATOR)
(504) 495-2727
Entity
Organization
Contact information
Practice address
4561 EDFIELD ST, HOUSTON, TX 77051-1909
(713) 425-3772
(713) 425-3772
Mailing address
4561 EDFIELD ST, HOUSTON, TX 77051-1909
(713) 425-3772
(713) 425-3772
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
—
—
261Q00000X
Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
—
261QP3300X
Pain Clinic/Center
—
—
261QX0100X
Occupational Medicine Clinic/Center
—
—
Other
Enumeration date
02/21/2019
Last updated
02/21/2019
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