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NPI Code Detail

MEDICARE: EL CENTRO DE CORAZON

MEDICARE: EL CENTRO DE CORAZON
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
11223S0112XOral and Maxillofacial Surgery (Dentist)
2172V00000XCommunity Health Worker
3261QF0400XFederally Qualified Health Center (FQHC)

General Provider Information

NPI Number : 1245556885
Entity Type Code : Organization
Provider Name (Legal Business Name) : EL CENTRO DE CORAZON
Provider Business Mailing Address
First Line : P.O. BOX 230209
Second Line :
City : HOUSTON
State : TX
Zip : 77223
Country : US
Telephone Number : 713-660-1880
Fax Number : 713-926-9105
Provider Business Practice Location Address
First Line : 7635 CANAL ST.
Second Line :
City : HOUSTON
State : TX
Zip : 77012-1143
Country : US
Telephone Number : 713-660-1880
Fax Number : 713-926-9105
Authorized Official
Title or Position : CEO
Name : MS. MARCELLE ELIZABETH MIR
Credential : MSW
Telephone Number : 713-660-1880
Provider Enumeration Date : 04/07/2010
Last Update Date : 12/13/2024

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Directions to “EL CENTRO DE CORAZON ” Practice Location

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