Basic Information
| Provider Information | |||||||||
| NPI: | 1518512094 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SANITAS MEDICAL CENTER OF TEXAS PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12586 WESTHEIMER RD | ||||||||
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| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770775865 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 12823 GULF FWY | ||||||||
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| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770344807 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3054702929 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/01/2019 | ||||||||
| LastUpdateDate: | 10/31/2019 | ||||||||
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| AuthorizedOfficialLastName: | HIGUERA | ||||||||
| AuthorizedOfficialFirstName: | ADRIANA | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 3054702929 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | SANITAS MEDICAL CENTER OF TEXAS PA | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.