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General NPI Number Information
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NPI Number | 1679787303
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Entity Type | Organization
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Legal Business Name | EBM AND ASSOCIATES P A
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 11830 FM 1960 RD W
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City | HOUSTON
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State | TX
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Zip | 77065-3840
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Country | US
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Telephone | 281-890-3010
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Fax | 281-894-6302
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Provider Business Mailing Address
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Address Line | 11830 FM 1960 RD W
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City | HOUSTON
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State | TX
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Zip | 77065-3840
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Country | US
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Telephone | 281-890-3010
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Fax | 281-894-6302
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EDWARD BRUCE MCCLENDON
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Credential | MD
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Telephone | 281-890-3010
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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 | F1792
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License Number State | TX
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