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General NPI Number Information
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NPI Number | 1861208720
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Entity Type | Organization
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Legal Business Name | OFFICIUM HEALTH PLLC
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Dates
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Enumeration Date | 12/05/2024
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 6408 WESTVIEW DR BUILDING B, UNIT # 2208
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City | HOUSTON
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State | TX
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Zip | 77055-7705
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Country | US
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Telephone | 760-372-6060
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Fax |
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Provider Business Mailing Address
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Address Line | 6408 WESTVIEW DR UNIT 2208
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City | HOUSTON
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State | TX
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Zip | 77055
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Country | US
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Telephone | 760-350-2498
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Fax | 866-554-1794
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | SRINIVAS VUTHOORI
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Credential | MD
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Telephone | 760-972-6060
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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