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NPI Code Detail

MEDICARE: PIN OAK MEDICAL CLINIC OF KATY

MEDICARE: PIN OAK MEDICAL CLINIC OF KATY
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
1207Q00000XFamily Medicine PhysicianF6235TX

General Provider Information

NPI Number : 1548357767
Entity Type Code : Organization
Provider Name (Legal Business Name) : PIN OAK MEDICAL CLINIC OF KATY
Provider Business Mailing Address
First Line : 19255 PARK ROW STE 203
Second Line :
City : HOUSTON
State : TX
Zip : 77084-7310
Country : US
Telephone Number : 281-646-8450
Fax Number : 888-880-7753
Provider Business Practice Location Address
First Line : 19255 PARK ROW STE 203
Second Line :
City : HOUSTON
State : TX
Zip : 77084-7310
Country : US
Telephone Number : 281-646-8450
Fax Number : 888-880-7753
Authorized Official
Title or Position : PRINCIPAL
Name : DR. LYNN R GIBBS
Credential : MD
Telephone Number : 281-646-8450
Provider Enumeration Date : 10/09/2006
Last Update Date : 06/13/2019

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Directions to “PIN OAK MEDICAL CLINIC OF KATY ” Practice Location

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