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General NPI Number Information
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NPI Number | 1649916701
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Entity Type | Organization
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Legal Business Name | POLIMED PRIMARY CARE, PLLC
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Dates
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Enumeration Date | 05/10/2022
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Last Update Date | 12/07/2023
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Provider Practice Location Address
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Address Line | 12600 N FEATHERWOOD DR STE 100
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City | HOUSTON
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State | TX
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Zip | 77034-4435
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Country | US
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Telephone | 281-709-6394
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Fax | 281-805-1914
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Provider Business Mailing Address
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Address Line | 12600 N FEATHERWOOD DR STE 100
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City | HOUSTON
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State | TX
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Zip | 77034-4435
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Country | US
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Telephone | 281-709-6394
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Fax | 281-805-1914
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. ADONIS LEOVIGILDO CASTILLO
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Credential | MD
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Telephone | 281-709-6394
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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