MEDICARE: WESTLAKE MEDICAL SERVICES LLLP

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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1447591029
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WESTLAKE MEDICAL SERVICES LLLP

Provider Business Mailing Address
First Line	:	2430 FRY RD STE 100
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77084-5831
Country	:	US
Telephone Number	:	281-829-3999
Fax Number	:	281-829-5146

Provider Business Practice Location Address
First Line	:	2430 FRY RD STE 100
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77084-5831
Country	:	US
Telephone Number	:	281-829-3999
Fax Number	:	281-829-5146

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. PHONG NGUYEN
Credential	:	M.D.
Telephone Number	:	281-829-3999

Provider Enumeration Date	:	03/07/2013
Last Update Date	:	06/22/2022

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Directions to “WESTLAKE MEDICAL SERVICES LLLP ” Practice Location

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