MEDICARE: CITY EAST MEDICAL PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207Q00000X	Family Medicine Physician
2	208D00000X	General Practice Physician
3	207R00000X	Internal Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386873057
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY EAST MEDICAL PA

Provider Business Mailing Address
First Line	:	7112 LYONS AVE
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77020-5361
Country	:	US
Telephone Number	:	713-672-2593
Fax Number	:	713-672-7477

Provider Business Practice Location Address
First Line	:	7112 LYONS AVE
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77020-5361
Country	:	US
Telephone Number	:	713-672-2593
Fax Number	:	713-672-7477

Authorized Official
Title or Position	:	MANAGER
Name	:	MR. PAUL CHENG
Credential	:
Telephone Number	:	713-672-2593

Provider Enumeration Date	:	07/02/2009
Last Update Date	:	07/02/2009

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Directions to “CITY EAST MEDICAL PA ” Practice Location

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