Healthcare Provider Details

I. General information

NPI: 1750562575
Provider Name (Legal Business Name): DIVERSIFIED MEDICAL PRACTICES, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2007
Last Update Date: 04/01/2021
Certification Date: 04/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6301 RICHMOND AVE STE 101
HOUSTON TX
77057-5905
US

IV. Provider business mailing address

6301 RICHMOND AVE STE 101
HOUSTON TX
77057-5905
US

V. Phone/Fax

Practice location:
  • Phone: 713-961-7100
  • Fax: 713-961-3085
Mailing address:
  • Phone: 713-961-7100
  • Fax: 713-961-3085

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberG0049
License Number StateTX

VIII. Authorized Official

Name: DR. PATRICIA DENISE SALVATO
Title or Position: OWNER
Credential: MD
Phone: 713-961-7100