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General NPI Number Information
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NPI Number | 1932104965
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Entity Type | Organization
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Legal Business Name | PASADENA HEALTH CENTER, INC
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Dates
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Enumeration Date | 06/16/2005
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Last Update Date | 05/07/2009
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Provider Practice Location Address
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Address Line | 908 SOUTHMORE AVE STE 100
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City | PASADENA
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State | TX
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Zip | 77502-1134
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Country | US
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Telephone | 713-554-1091
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Fax | 713-554-1096
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Provider Business Mailing Address
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Address Line | 908 SOUTHMORE AVE. STE 100
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City | PASADENA
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State | TX
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Zip | 77502-1120
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Country | US
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Telephone | 713-554-1091
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Fax | 713-554-1096
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. JOHN MICHAEL SWEITZER
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Credential |
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Telephone | 713-554-1091
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number | M8383
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number | 21495
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number | 19719
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number | M8570
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License Number State | TX
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