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NPI Code Detail

MEDICARE: INSTITUTE ON HEALTHY AGING

MEDICARE: INSTITUTE ON HEALTHY AGING
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
1261QM1300XMulti-Specialty Clinic/Center

General Provider Information

NPI Number : 1154880490
Entity Type Code : Organization
Provider Name (Legal Business Name) : INSTITUTE ON HEALTHY AGING
Provider Business Mailing Address
First Line : 9406 FERN WOOD FRST
Second Line :
City : HOUSTON
State : TX
Zip : 77040-6892
Country : US
Telephone Number : 713-291-1567
Fax Number :
Provider Business Practice Location Address
First Line : 9406 FERN WOOD FRST
Second Line :
City : HOUSTON
State : TX
Zip : 77040-6892
Country : US
Telephone Number : 713-291-1567
Fax Number :
Authorized Official
Title or Position : CEO
Name : ASHEVA PHILLIPS
Credential :
Telephone Number : 713-291-1567
Provider Enumeration Date : 03/17/2019
Last Update Date : 03/17/2019

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Directions to “INSTITUTE ON HEALTHY AGING ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.