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General NPI Number Information
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NPI Number | 1295440899
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Entity Type | Organization
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Legal Business Name | COMMUNITY CARE CONSULTANTS
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Dates
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Enumeration Date | 01/18/2023
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Last Update Date | 01/18/2023
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Provider Practice Location Address
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Address Line | 6035 NORTHDALE ST
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City | HOUSTON
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State | TX
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Zip | 77087-5034
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Country | US
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Telephone | 346-226-7032
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Fax | 346-226-7033
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Provider Business Mailing Address
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Address Line | 6035 NORTHDALE ST
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City | HOUSTON
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State | TX
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Zip | 77087-5034
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Country | US
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Telephone | 979-943-1039
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Fax |
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Authorized Official
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Title or Position | ADMIN
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Name | TE-JUAN ANDERSON
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Credential |
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Telephone | 979-943-1039
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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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