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NPI Code Detail

MEDICARE: AIRLINE FAMILY PRACTICE ASSOCIATES, INC

MEDICARE: AIRLINE FAMILY PRACTICE ASSOCIATES, INC
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
1208000000XPediatrics Physician
2207Q00000XFamily Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
20076NPOTHERTXBCBS GROUP
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1386744142
Entity Type Code : Organization
Provider Name (Legal Business Name) : AIRLINE FAMILY PRACTICE ASSOCIATES, INC
Provider Business Mailing Address
First Line : 11012 AIRLINE DR STE A
Second Line :
City : HOUSTON
State : TX
Zip : 77037-1112
Country : US
Telephone Number : 281-820-8955
Fax Number : 281-820-5541
Provider Business Practice Location Address
First Line : 11012 AIRLINE DR STE A
Second Line :
City : HOUSTON
State : TX
Zip : 77037-1112
Country : US
Telephone Number : 281-820-8955
Fax Number : 281-820-5541
Authorized Official
Title or Position : ADMINISTRATOR
Name : MR. JOSE I GONZALEZ JR.
Credential :
Telephone Number : 713-447-1375
Provider Enumeration Date : 09/22/2006
Last Update Date : 01/05/2023

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Directions to “AIRLINE FAMILY PRACTICE ASSOCIATES, INC ” Practice Location

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