Healthcare Provider Details

I. General information

NPI: 1669908927
Provider Name (Legal Business Name): PRIMERO HEALTH, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2017
Last Update Date: 05/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 E 7TH ST
AUSTIN TX
78702-2712
US

IV. Provider business mailing address

1701 E 7TH ST
AUSTIN TX
78702-2712
US

V. Phone/Fax

Practice location:
  • Phone: 512-433-1796
  • Fax:
Mailing address:
  • Phone: 512-433-1796
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name: LILIA VELA
Title or Position: CEO
Credential:
Phone: 512-433-1796