290 MANGUM HEALTHCARE LLC

NPI 1164726956 Active Family Medicine, Adult Medicine

Quick Facts

NPI Number

1164726956

Type

Organization (NPI-2)

Status

Active

Enumeration Date

2011-01-07

Last Updated (NPPES)

2011-01-07

Primary Specialty / Taxonomy

Taxonomy	Family Medicine, Adult Medicine
Taxonomy Code	`207QA0505X`
License	PA01537 TX

Practice Address

5005 W 34TH ST
SUITE 102C
HOUSTON, TX 770924200

Phone: 713-682-2212

Fax: 713-682-9997

Data sourced live from the CMS NPPES NPI Registry (npiregistry.cms.hhs.gov) and cached locally. This is a public directory lookup, not a credentialing or verification service — confirm critical details directly with NPPES or the provider.