Healthcare Provider Details

I. General information

NPI: 1093390049
Provider Name (Legal Business Name): PHYSICIAN ASSOCIATES OF TEXAS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2021
Last Update Date: 10/22/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2306 RAYFORD RD
SPRING TX
77386-1707
US

IV. Provider business mailing address

2306 RAYFORD RD
SPRING TX
77386-1707
US

V. Phone/Fax

Practice location:
  • Phone: 281-453-7777
  • Fax:
Mailing address:
  • Phone: 281-453-7777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HUONG LE
Title or Position: AUTHORIZED OFFICIAL
Credential: MD
Phone: 281-453-7777