MEDICARE: TRISTAR MEDICAL MANAGEMENT

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1720472251
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRISTAR MEDICAL MANAGEMENT

Provider Business Mailing Address
First Line	:	7111 HARWIN DR STE 210
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77036-2141
Country	:	US
Telephone Number	:	713-339-1471
Fax Number	:

Provider Business Practice Location Address
First Line	:	7111 HARWIN DR STE 210
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77036-2141
Country	:	US
Telephone Number	:	713-339-1471
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. RAYMOND P KWONG
Credential	:
Telephone Number	:	713-339-1471

Provider Enumeration Date	:	03/23/2015
Last Update Date	:	12/15/2015

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Directions to “TRISTAR MEDICAL MANAGEMENT ” Practice Location

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