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General NPI Number Information
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NPI Number | 1295053023
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Entity Type | Organization
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Legal Business Name | CAL TEX MEDICAL MANAGEMENT ASSOCIATES, LLC
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Dates
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Enumeration Date | 05/04/2010
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Last Update Date | 05/04/2010
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Provider Practice Location Address
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Address Line | 908 E SOUTHMORE AVE STE 340
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City | PASADENA
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State | TX
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Zip | 77502-1133
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Country | US
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Telephone | 713-589-1435
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Fax | 713-589-1439
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Provider Business Mailing Address
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Address Line | P.O.BOX 299
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City | RICHMOND
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State | TX
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Zip | 77406
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Country | US
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Telephone | 713-589-1435
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Fax | 713-589-1439
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Authorized Official
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Title or Position | PHYSICIAN ASSISTANT
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Name | MR. ROBERT CAIN JR.
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Credential | PA-C
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Telephone | 619-871-3252
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | PA04517
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License Number State | TX
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