Healthcare Provider Details

I. General information

NPI: 1780635425
Provider Name (Legal Business Name): SPECTRUM CARE P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 10/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6100 RICHMOND # 120
HOUSTON TX
77057
US

IV. Provider business mailing address

6100 RICHMOND # 120
HOUSTON TX
77057
US

V. Phone/Fax

Practice location:
  • Phone: 832-242-7500
  • Fax: 832-242-7800
Mailing address:
  • Phone: 832-242-7500
  • Fax: 832-242-7800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number261QM0801X
License Number StateTX

VIII. Authorized Official

Name: DR. MANSOUR R SANJAR
Title or Position: OWNER
Credential: M.D.
Phone: 832-242-7500