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NPI Code Detail

MEDICARE: CHAMPIONS POINT FAMILY CLINIC LLC

MEDICARE: CHAMPIONS POINT FAMILY CLINIC LLC
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
1261QP2300XPrimary Care Clinic/Center
2207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1528555307
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHAMPIONS POINT FAMILY CLINIC LLC
Provider Business Mailing Address
First Line : 5367 W RICHEY RD
Second Line :
City : HOUSTON
State : TX
Zip : 77066-3323
Country : US
Telephone Number : 281-895-3008
Fax Number :
Provider Business Practice Location Address
First Line : 5367 W RICHEY RD
Second Line :
City : HOUSTON
State : TX
Zip : 77066
Country : US
Telephone Number : 713-423-4157
Fax Number :
Authorized Official
Title or Position : MEMBER/FNP-C
Name : DR. RAQUEL TORRES
Credential : DNP, FNP-C
Telephone Number : 281-895-3008
Provider Enumeration Date : 04/17/2018
Last Update Date : 07/15/2018

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Directions to “CHAMPIONS POINT FAMILY CLINIC LLC ” Practice Location

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