Healthcare Provider Details

I. General information

NPI: 1700247079
Provider Name (Legal Business Name): LEAGUE CITY FAMILY CLINIC, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2016
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1507 WEST LEAGUE CITY PARKWAY SUITE 200
LEAGUE CITY TX
77573-6768
US

IV. Provider business mailing address

1507 WEST LEAGUE CITY PARKWAY SUITE 200
LEAGUE CITY TX
77573-6768
US

V. Phone/Fax

Practice location:
  • Phone: 281-525-6290
  • Fax: 832-905-6173
Mailing address:
  • Phone: 281-525-6290
  • Fax: 832-905-6173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberM9365
License Number StateTX

VIII. Authorized Official

Name: DR. HANAN HUSSEIN
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 281-525-6290