MEDICARE: FAMILY PHYSICIAN,P.A.

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	M0297	TX

Other Identifiers

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

General Provider Information

NPI Number	:	1447435284
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY PHYSICIAN,P.A.

Provider Business Mailing Address
First Line	:	9119 S GESSNER DR
Second Line	:	SUITE 305
City	:	HOUSTON
State	:	TX
Zip	:	77074-2874
Country	:	US
Telephone Number	:	713-772-5669
Fax Number	:

Provider Business Practice Location Address
First Line	:	9119 S GESSNER DR
Second Line	:	SUITE 305
City	:	HOUSTON
State	:	TX
Zip	:	77074-2874
Country	:	US
Telephone Number	:	713-772-5669
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MR. KENNETH OKEFIE UZOAGA
Credential	:
Telephone Number	:	713-772-5669

Provider Enumeration Date	:	12/28/2007
Last Update Date	:	08/20/2013

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