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NPI Code Detail

MEDICARE: POLICLINICA SALUD Y VIDA

MEDICARE: POLICLINICA SALUD Y VIDA
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
1261QH0100XHealth Service Clinic/Center

General Provider Information

NPI Number : 1710227442
Entity Type Code : Organization
Provider Name (Legal Business Name) : POLICLINICA SALUD Y VIDA
Provider Business Mailing Address
First Line : 6633 HILLCROFT ST
Second Line : SUITE 261
City : HOUSTON
State : TX
Zip : 77081-4887
Country : US
Telephone Number : 281-975-8601
Fax Number :
Provider Business Practice Location Address
First Line : 6633 HILLCROFT ST
Second Line : SUITE 261
City : HOUSTON
State : TX
Zip : 77081-4887
Country : US
Telephone Number : 281-975-8601
Fax Number :
Authorized Official
Title or Position : OWNER
Name : JUAN J ELIZALDE GALLEGOS
Credential :
Telephone Number : 281-975-8601
Provider Enumeration Date : 02/16/2013
Last Update Date : 02/16/2013

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Directions to “POLICLINICA SALUD Y VIDA ” Practice Location

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