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General NPI Number Information
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NPI Number | 1497430128
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Entity Type | Organization
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Legal Business Name | KINGSPOINT HOME VISITING PHYSICIANS
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Dates
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Enumeration Date | 06/20/2023
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Last Update Date | 06/27/2024
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Provider Practice Location Address
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Address Line | 14200 GULF FWY
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City | HOUSTON
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State | TX
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Zip | 77034-5369
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Country | US
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Telephone | 832-774-1330
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Fax |
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Provider Business Mailing Address
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Address Line | 10 SANTA CLARITA CIR
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City | MANVEL
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State | TX
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Zip | 77578-3352
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Country | US
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Telephone | 832-774-1330
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | MR. BERTRAND K EBANG
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Credential |
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Telephone | 832-774-1330
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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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