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General NPI Number Information
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NPI Number | 1932472453
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Entity Type | Organization
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Legal Business Name | US PUBLIC HEALTH SERVICES
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Dates
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Enumeration Date | 02/14/2012
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Last Update Date | 02/14/2012
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Provider Practice Location Address
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Address Line | 15850 EXPORT PLAZA DRIVE
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City | HOUSTON
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State | TX
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Zip | 77032
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Country | US
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Telephone | 281-985-8511
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Fax |
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Provider Business Mailing Address
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Address Line | 15850 EXPORT PLAZA DRIVE
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City | HOUSTON
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State | TX
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Zip | 77032
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Country | US
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Telephone | 281-985-8511
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Fax |
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Authorized Official
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Title or Position | ASSISTANT DIRECTOR FOR ICE HEALTH S
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Name | DR. JON KROHMER
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Credential | MD
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Telephone | 202-732-4600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP0904X
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Taxonomy Name | Federal Public Health Clinic/Center
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License Number | PA 9103676
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License Number State | FL
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