Healthcare Provider Details

I. General information

NPI: 1043141708
Provider Name (Legal Business Name): MEDICAL PRACTICE MANAGEMENT ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3602 BLUE CYPRESS DR
SPRING TX
77388-5709
US

IV. Provider business mailing address

3602 BLUE CYPRESS DR
SPRING TX
77388-5709
US

V. Phone/Fax

Practice location:
  • Phone: 281-595-0069
  • Fax: 281-595-0067
Mailing address:
  • Phone: 281-595-0069
  • Fax: 281-595-0067

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: LOVELL DAVIS
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 757-572-6686