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General NPI Number Information
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NPI Number | 1275717720
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Entity Type | Organization
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Legal Business Name | SOUTHWEST COMMUNITY CLINIC
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Dates
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Enumeration Date | 12/19/2007
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 8303 SOUTHWEST FWY 320
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City | HOUSTON
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State | TX
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Zip | 77074-1600
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Country | US
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Telephone | 713-771-5003
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Fax | 713-771-4494
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Provider Business Mailing Address
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Address Line | 8303 SOUTHWEST FWY 320
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City | HOUSTON
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State | TX
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Zip | 77074-1600
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Country | US
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Telephone | 713-771-5003
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Fax | 713-771-4494
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Authorized Official
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Title or Position | SENIOR VICE PRESIDENT
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Name | MRS. EUNICE O OGBEBOR
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Credential |
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Telephone | 713-771-5003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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