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General NPI Number Information
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NPI Number | 1154568285
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Entity Type | Organization
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Legal Business Name | UNIVERSAL PREVENTIVE HELTH CARE INC
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Dates
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Enumeration Date | 01/12/2009
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Last Update Date | 01/12/2009
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Provider Practice Location Address
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Address Line | 1917 N MAIN ST SUITE C
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City | HOUSTON
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State | TX
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Zip | 77009-8358
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Country | US
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Telephone | 713-227-4400
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Fax |
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Provider Business Mailing Address
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Address Line | 1917 N MAIN ST SUITE C
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City | HOUSTON
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State | TX
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Zip | 77009-8358
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Country | US
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Telephone | 713-227-4400
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | INGA ZUEVA
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Credential |
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Telephone | 323-445-0700
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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 | K7454
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License Number State | TX
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