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General NPI Number Information
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NPI Number | 1619383528
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Entity Type | Organization
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Legal Business Name | PREFERRED PRIMARY CARE
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Dates
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Enumeration Date | 07/11/2014
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Last Update Date | 07/11/2014
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Provider Practice Location Address
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Address Line | 1450 W GRAND PKWY S
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City | KATY
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State | TX
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Zip | 77494-8286
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Country | US
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Telephone | 832-437-8467
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Fax |
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Provider Business Mailing Address
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Address Line | 26702 ROCKY LANDING LN
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City | KATY
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State | TX
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Zip | 77494-2720
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Country | US
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Telephone | 832-437-8467
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. QAMAR RAZA
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Credential | MD
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Telephone | 419-204-8365
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | N9942
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License Number State | TX
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