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General NPI Number Information
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NPI Number | 1376714303
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Entity Type | Organization
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Legal Business Name | AUGUSTA FAMILY MEDICINE ASSOCIATES P.A.
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Dates
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Enumeration Date | 03/18/2008
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Last Update Date | 07/07/2008
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Provider Practice Location Address
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Address Line | 2951 CHIMNEY ROCK RD STE D
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City | HOUSTON
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State | TX
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Zip | 77056-5937
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Country | US
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Telephone | 713-977-2970
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Fax | 713-977-3479
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Provider Business Mailing Address
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Address Line | 2951 CHIMNEY ROCK RD
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City | HOUSTON
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State | TX
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Zip | 77056-5937
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. THOMAS NGUYEN
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Credential |
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Telephone | 713-977-2970
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | J8698
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License Number State | TX
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