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General NPI Number Information
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NPI Number | 1003154063
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Entity Type | Organization
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Legal Business Name | DPMC LLC
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Dates
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Enumeration Date | 01/26/2013
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Last Update Date | 01/26/2013
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Provider Practice Location Address
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Address Line | 2630 FOUNTAIN VIEW DR SUITE 409
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City | HOUSTON
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State | TX
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Zip | 77057-7608
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Country | US
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Telephone | 713-588-1425
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Fax | 713-588-1424
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Provider Business Mailing Address
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Address Line | 2630 FOUNTAIN VIEW DR SUITE 409
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City | HOUSTON
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State | TX
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Zip | 77057-7608
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Country | US
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Telephone | 713-588-1425
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Fax | 713-588-1424
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Authorized Official
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Title or Position | DIRECTOR
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Name | GARY KRAFT
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Credential |
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Telephone | 713-588-1425
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State | TX
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