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NPI Code Detail

MEDICARE: PRIMARY MEDICINE CENTER LLC

MEDICARE: PRIMARY MEDICINE CENTER LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician
2207R00000XInternal Medicine Physician
31041C0700XClinical Social Worker
4101YM0800XMental Health Counselor
5106H00000XMarriage & Family Therapist
62084P0800XPsychiatry Physician

General Provider Information

NPI Number : 1063470912
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRIMARY MEDICINE CENTER LLC
Provider Business Mailing Address
First Line : 7707 FANNIN ST
Second Line : SUITE 205
City : HOUSTON
State : TX
Zip : 77054-1926
Country : US
Telephone Number : 713-790-0745
Fax Number : 713-790-1302
Provider Business Practice Location Address
First Line : 7707 FANNIN ST
Second Line : SUITE 205
City : HOUSTON
State : TX
Zip : 77054-1926
Country : US
Telephone Number : 713-790-0745
Fax Number : 713-790-1302
Authorized Official
Title or Position : CEO
Name : MR. TERRY SCOVILL
Credential :
Telephone Number : 713-790-0745
Provider Enumeration Date : 05/02/2006
Last Update Date : 12/06/2007

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Directions to “PRIMARY MEDICINE CENTER LLC ” Practice Location

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