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General NPI Number Information
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NPI Number | 1609254135
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Entity Type | Organization
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Legal Business Name | ECONO SALUD,PLLC
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Dates
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Enumeration Date | 05/17/2015
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Last Update Date | 05/17/2015
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Provider Practice Location Address
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Address Line | 8118 LONG POINT RD
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City | HOUSTON
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State | TX
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Zip | 77055-2006
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Country | US
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Telephone | 832-525-5032
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Fax |
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Provider Business Mailing Address
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Address Line | 7202 TURTLE LAGOON ROW
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City | HOUSTON
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State | TX
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Zip | 77036-4416
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Country | US
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Telephone | 832-525-5032
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. STAN LEE GORE
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Credential | NP-C
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Telephone | 832-525-5032
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 535364
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License Number State | TX
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