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General NPI Number Information
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NPI Number | 1295975894
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Entity Type | Organization
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Legal Business Name | SOUTHWEST TOTAL MEDICAL CLINIC INC
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Dates
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Enumeration Date | 02/23/2009
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Last Update Date | 03/04/2016
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Provider Practice Location Address
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Address Line | 12601 WESTHEIMER ROAD SUITE C
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City | HOUSTON
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State | TX
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Zip | 77077-5702
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Country | US
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Telephone | 281-293-0222
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Fax | 832-767-2315
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Provider Business Mailing Address
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Address Line | 12601 WESTHEIMER ROAD SUITE C
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City | HOUSTON
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State | TX
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Zip | 77077-5702
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Country | US
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Telephone | 281-293-0222
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Fax | 832-767-2315
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Authorized Official
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Title or Position | PRESIDENT/PARTNER
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Name | MRS. ANN SHEPHERD
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Credential |
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Telephone | 281-293-0222
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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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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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