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General NPI Number Information
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NPI Number | 1689689556
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Entity Type | Organization
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Legal Business Name | CONTEMPORARY FAMILY MEDICINE TRUST
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Dates
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Enumeration Date | 07/29/2006
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Last Update Date | 07/19/2010
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Provider Practice Location Address
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Address Line | 200 EAST BOOTHE # 100
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City | CLEVELAND
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State | TX
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Zip | 77327-4063
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Country | US
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Telephone | 281-592-2888
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Fax | 281-361-6322
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Provider Business Mailing Address
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Address Line | 200 E BOOTHE SUITE 100
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City | CLEVELAND
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State | TX
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Zip | 77327-4063
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Country | US
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Telephone | 281-592-2888
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Fax | 281-361-6322
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Authorized Official
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Title or Position | MANAGER
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Name | GEORGE N STOKES
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Credential | MD
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Telephone | 281-592-2888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 4500921162
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License Number State |
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