PRESTIGE MEDICAL P A NPI 1174654750

NPI Information

NPI: 1174654750
Provider Name: PRESTIGE MEDICAL P A
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 45D1068395

Address:
3945 COUNTY ROAD 58
MANVEL, TX
ZIP 77578
Phone: (281) 412-6606
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PRESTIGE MEDICAL P A is a primary care clinic center in Manvel, TX. PRESTIGE MEDICAL P A NPI is 1174654750. The provider is registered as an organization entity type.

The provider's business location address is:

3945 COUNTY ROAD 58
MANVEL, TX
ZIP 77578-903
Phone: (281) 412-6606
Fax: (281) 489-0233

The provider's authorized official is Jeevan R Santha .
The authorized official title is Practice Manager and has the following contact phone number (281) 923-4112.

The CLIA number assigned to this NPI record is 45D1068395 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/8/2007 and was last updated on 2/1/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	L7625	TEXAS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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