Healthcare Provider Details
I. General information
NPI: 1275198509
Provider Name (Legal Business Name): ASIAN AMERICAN HEALTH COALITION OF THE GREATER HOUSTON AREA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/02/2019
Last Update Date: 02/02/2023
Certification Date: 02/02/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3000 ALDINE MAIL ROUTE RD, BUILDING C, STE 200
HOUSTON TX
77039
US
IV. Provider business mailing address
7001 CORPORATE DR STE 120
HOUSTON TX
77036-5113
US
V. Phone/Fax
- Phone: 713-773-0803
- Fax:
- Phone: 713-773-0803
- Fax: 713-275-0951
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QF0400X |
| Taxonomy | Federally Qualified Health Center (FQHC) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ANDREA
CARACOSTIS
Title or Position: CEO
Credential:
Phone: 713-773-0803