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General NPI Number Information
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NPI Number | 1912439852
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Entity Type | Organization
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Legal Business Name | CENTRA CLINIC- II INC
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Dates
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Enumeration Date | 03/30/2017
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Last Update Date | 05/04/2017
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Provider Practice Location Address
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Address Line | 3751 SOUTH DAIRY ASHFORD ROAD
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City | HOUSTON
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State | TX
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Zip | 77082-5614
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Country | US
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Telephone | 832-328-0044
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Fax |
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Provider Business Mailing Address
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Address Line | 3751 SOUTH DAIRY ASHFORD RD
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City | HOUSTON
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State | TX
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Zip | 77082
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Country | US
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Telephone | 832-328-0044
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Fax |
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Authorized Official
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Title or Position | PROPRIETOR
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Name | DR. YAA AMOAH-HONNY
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Credential | M.D.
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Telephone | 832-328-0044
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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 | L0748
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License Number State | TX
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