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General NPI Number Information
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NPI Number | 1063572139
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Entity Type | Organization
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Legal Business Name | TOMBALL PRIMARY CARE PA
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 10/17/2008
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Provider Practice Location Address
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Address Line | 1101 ALMA ST SUITE 104
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City | TOMBALL
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State | TX
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Zip | 77375-4554
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Country | US
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Telephone | 281-290-0018
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Fax | 281-290-0064
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Provider Business Mailing Address
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Address Line | 1101 ALMA ST SUITE 104
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City | TOMBALL
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State | TX
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Zip | 77375-4554
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Country | US
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Telephone | 281-290-0018
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Fax | 281-290-0064
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN F GILMORE
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Credential | MD
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Telephone | 281-290-0018
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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