Healthcare Provider Details

I. General information

NPI: 1861208720
Provider Name (Legal Business Name): OFFICIUM HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2024
Last Update Date: 12/05/2024
Certification Date: 12/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6408 WESTVIEW DR BUILDING B, UNIT # 2208
HOUSTON TX
77055-7705
US

IV. Provider business mailing address

6408 WESTVIEW DR UNIT 2208
HOUSTON TX
77055
US

V. Phone/Fax

Practice location:
  • Phone: 760-372-6060
  • Fax:
Mailing address:
  • Phone: 760-350-2498
  • Fax: 866-554-1794

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SRINIVAS VUTHOORI
Title or Position: PRESIDENT/CEO
Credential: MD
Phone: 760-972-6060