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NPI Code Detail

MEDICARE: DOWNTOWN PERFORMANCE MEDICAL CENTER, INC

MEDICARE: DOWNTOWN PERFORMANCE MEDICAL CENTER, INC
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
1101YP2500XProfessional Counselor19765TX
2111N00000XChiropractor9768TX
3207Q00000XFamily Medicine PhysicianF0548TX
4111N00000XChiropractor8723TX

General Provider Information

NPI Number : 1790720399
Entity Type Code : Organization
Provider Name (Legal Business Name) : DOWNTOWN PERFORMANCE MEDICAL CENTER, INC
Provider Business Mailing Address
First Line : 3033 FANNIN ST
Second Line :
City : HOUSTON
State : TX
Zip : 77004-3258
Country : US
Telephone Number : 713-652-0011
Fax Number : 713-652-0015
Provider Business Practice Location Address
First Line : 3033 FANNIN ST
Second Line :
City : HOUSTON
State : TX
Zip : 77004-3258
Country : US
Telephone Number : 713-652-0011
Fax Number : 713-652-0015
Authorized Official
Title or Position : CEO
Name : LONIE NGUYEN
Credential :
Telephone Number : 327-247-2018
Provider Enumeration Date : 06/18/2006
Last Update Date : 03/07/2019

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