MEDICARE: CLINICA HISPANA HAMMERLY

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

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	:	1649091372
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLINICA HISPANA HAMMERLY

Provider Business Mailing Address
First Line	:	10131 HAMMERLY BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77080-5014
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10131 HAMMERLY BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77080-5014
Country	:	US
Telephone Number	:	713-769-0096
Fax Number	:	713-769-0094

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	JOSEPH A MONTES
Credential	:	MD
Telephone Number	:	713-769-0096

Provider Enumeration Date	:	10/24/2024
Last Update Date	:	11/06/2024

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Directions to “CLINICA HISPANA HAMMERLY ” Practice Location

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