Healthcare Provider Details

I. General information

NPI: 1457926149
Provider Name (Legal Business Name): PHM CONCEPTS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2021
Last Update Date: 10/11/2021
Certification Date: 10/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6402 LOUETTA RD STE 140
SPRING TX
77379-7582
US

IV. Provider business mailing address

6402 LOUETTA RD STE 140
SPRING TX
77379-7582
US

V. Phone/Fax

Practice location:
  • Phone: 281-251-8700
  • Fax: 281-251-8701
Mailing address:
  • Phone: 281-251-8700
  • Fax: 281-251-8701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: LORI WISDOM
Title or Position: OWNER
Credential: APRN, FNP-BC, ENP
Phone: 281-251-8700