Healthcare Provider Details

I. General information

NPI: 1346326113
Provider Name (Legal Business Name): AMBROSE MOBILE HEALTH CARE ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 03/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3663 N SAM HOUSTON PKWY E STE 625
HOUSTON TX
77032-3600
US

IV. Provider business mailing address

PO BOX 270926
HOUSTON TX
77277-0926
US

V. Phone/Fax

Practice location:
  • Phone: 281-441-3311
  • Fax: 281-441-3313
Mailing address:
  • Phone: 281-441-3311
  • Fax: 281-441-3313

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1100X
TaxonomyOphthalmic Technician/Technologist
License Number
License Number State

VIII. Authorized Official

Name: DR. FIAZ ZAMAN
Title or Position: OWNER
Credential: MD
Phone: 281-441-3311