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General NPI Number Information
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NPI Number | 1295217990
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Entity Type | Organization
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Legal Business Name | LIFE CARE PRIMARY MEDICAL ASSOCIATES PLLC
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Dates
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Enumeration Date | 08/30/2018
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Last Update Date | 10/26/2023
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Provider Practice Location Address
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Address Line | 7103 S PEEK RD STE 520
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City | RICHMOND
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State | TX
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Zip | 77407-3498
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Country | US
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Telephone | 281-712-7757
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Fax | 281-712-7758
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Provider Business Mailing Address
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Address Line | 11569 S HIGHWAY 6 PMB # 209
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City | SUGAR LAND
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State | TX
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Zip | 77498-4932
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Country | US
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Telephone | 281-712-7757
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Fax | 281-712-7758
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. SAMIRA KHAN
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Credential | MD
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Telephone | 832-209-0611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | R6215
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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