MEDICARE: 1960 FAMILY PRACTICE, PA

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
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1285032839
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	1960 FAMILY PRACTICE, PA

Provider Business Mailing Address
First Line	:	847 CYPRESS CREEK PKWY
Second Line	:	100A
City	:	HOUSTON
State	:	TX
Zip	:	77090-3426
Country	:	US
Telephone Number	:	281-586-3888
Fax Number	:	281-440-2020

Provider Business Practice Location Address
First Line	:	847 CYPRESS CREEK PKWY
Second Line	:	100A
City	:	HOUSTON
State	:	TX
Zip	:	77090-3426
Country	:	US
Telephone Number	:	281-586-3888
Fax Number	:	281-440-2020

Authorized Official
Title or Position	:	AUTHORIZED OFFIIAL
Name	:	HUONG LE
Credential	:	MD
Telephone Number	:	281-586-3888

Provider Enumeration Date	:	12/15/2014
Last Update Date	:	12/15/2014

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Directions to “1960 FAMILY PRACTICE, PA ” Practice Location

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