Provider Demographics
NPI:1043691017
Name:MIDTOWN FAMILY CLINIC, INC.
Entity Type:Organization
Organization Name:MIDTOWN FAMILY CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MKRTICH
Authorized Official - Middle Name:MIKE
Authorized Official - Last Name:YEPREMIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-391-4444
Mailing Address - Street 1:2101 CRAWFORD ST
Mailing Address - Street 2:SUITE 208
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-8942
Mailing Address - Country:US
Mailing Address - Phone:713-759-1641
Mailing Address - Fax:713-759-9004
Practice Address - Street 1:2101 CRAWFORD ST
Practice Address - Street 2:SUITE 208
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-8942
Practice Address - Country:US
Practice Address - Phone:713-759-1641
Practice Address - Fax:713-759-9004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-15
Last Update Date:2015-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL8304208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty