Basic Information
| Provider Information | |||||||||
| NPI: | 1851549851 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | WESTWOOD PRIMARY CARE, PLLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | MAGNOLIA FAMILY MEDICINE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6912 FM 1488 RD STE A | ||||||||
| Address2: | |||||||||
| City: | MAGNOLIA | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773541527 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2813561945 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 6912 FM 1488 RD STE A | ||||||||
| Address2: | |||||||||
| City: | MAGNOLIA | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773541527 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2813561945 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/03/2008 | ||||||||
| LastUpdateDate: | 07/13/2012 | ||||||||
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| AuthorizedOfficialLastName: | ELHAJJ | ||||||||
| AuthorizedOfficialFirstName: | FERAS | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 2813561945 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | M.D | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP2300X | L5197 | TX | Y | Ambulatory Health Care Facilities | Clinic/Center | Primary Care |
No ID Information.