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General NPI Number Information
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NPI Number | 1407676547
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Entity Type | Organization
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Legal Business Name | GREATER HOUSTON FAMILY PRACTICE LLC
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Dates
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Enumeration Date | 10/14/2024
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 320 KINGWOOD EXECUTIVE DR STE B
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City | KINGWOOD
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State | TX
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Zip | 77339-2769
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Country | US
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Telephone | 346-330-6856
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 540088
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City | HOUSTON
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State | TX
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Zip | 77254-0088
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Country | US
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Telephone | 713-950-1190
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Fax | 713-950-1327
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Authorized Official
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Title or Position | OWNER
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Name | MAIMOONA Q NIZAMI
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Credential | MD
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Telephone | 463-306-8563
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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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