Healthcare Provider Details

I. General information

NPI: 1356816789
Provider Name (Legal Business Name): FORT BEND FAMILY HEALTH CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2018
Last Update Date: 10/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 AUSTIN ST
RICHMOND TX
77469-4498
US

IV. Provider business mailing address

400 AUSTIN ST
RICHMOND TX
77469-4498
US

V. Phone/Fax

Practice location:
  • Phone: 281-342-4530
  • Fax: 281-633-3192
Mailing address:
  • Phone: 281-342-4530
  • Fax: 281-633-3192

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: ALEXANDRA DOTY
Title or Position: DIRECTOR OF REVENUE CYCLE
Credential:
Phone: 832-600-6183