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General NPI Number Information
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NPI Number | 1215356985
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Entity Type | Organization
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Legal Business Name | EAST HOUSTON PRIMARY CARE, PLLC
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Dates
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Enumeration Date | 04/10/2014
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Last Update Date | 11/21/2025
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Provider Practice Location Address
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Address Line | 155055 EAST FREEWAY
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City | CHANNELVIEW
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State | TX
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Zip | 77530
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Country | US
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Telephone | 281-452-4747
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Fax |
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Provider Business Mailing Address
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Address Line | 2000 HEALTH PARK DR
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City | BRENTWOOD
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State | TN
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Zip | 37027-4692
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Country | US
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Telephone | 615-373-7406
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Fax |
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Authorized Official
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Title or Position | GROUP VICE PRESIDENT
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Name | NICHOLAS WADLINGTON
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Credential |
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Telephone | 615-372-7332
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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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