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General NPI Number Information
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NPI Number | 1942955265
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Entity Type | Organization
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Legal Business Name | HOUSTON HEALTH & SPORTS MEDICINE
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Dates
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Enumeration Date | 02/15/2022
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Last Update Date | 02/15/2022
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Provider Practice Location Address
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Address Line | 9180 PINECROFT DR # 390
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City | SHENANDOAH
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State | TX
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Zip | 77380-2794
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Country | US
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Telephone | 281-939-5655
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Fax |
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Provider Business Mailing Address
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Address Line | 742 SADDLEWOOD CIR
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City | SHENANDOAH
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State | TX
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Zip | 77381-1038
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DOMINIC MANEEN
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Credential | DO
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Telephone | 832-655-4774
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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