Healthcare Provider Details

I. General information

NPI: 1104659135
Provider Name (Legal Business Name): GENERAL CARE HEALTH MANAGEMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2024
Last Update Date: 08/23/2024
Certification Date: 08/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2124 CLINTON DR
GALENA PARK TX
77547-2839
US

IV. Provider business mailing address

7218 HARRISBURG BLVD
HOUSTON TX
77011-4737
US

V. Phone/Fax

Practice location:
  • Phone: 346-613-5570
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JOSE FLORES
Title or Position: MANAGER
Credential:
Phone: 832-538-9188