MEDICARE: PHYSICIANS ACO, LLC

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	305R00000X	Preferred Provider Organization

General Provider Information

NPI Number	:	1952777401
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSICIANS ACO, LLC

Provider Business Mailing Address
First Line	:	1900 NORTH LOOP W STE 400
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77018-8119
Country	:	US
Telephone Number	:	281-447-6800
Fax Number	:	281-447-6802

Provider Business Practice Location Address
First Line	:	1900 NORTH LOOP W STE 400
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77018-8119
Country	:	US
Telephone Number	:	281-447-6800
Fax Number	:	281-447-6802

Authorized Official
Title or Position	:	COO
Name	:	JENNIFER DAVIS
Credential	:
Telephone Number	:	281-447-6800

Provider Enumeration Date	:	08/19/2015
Last Update Date	:	08/19/2015

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Directions to “PHYSICIANS ACO, LLC ” Practice Location

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