Provider Demographics
NPI:1063509891
Name:DOWNTOWN PERFORMANCE MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:DOWNTOWN PERFORMANCE MEDICAL CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LAN
Authorized Official - Middle Name:T
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-652-0011
Mailing Address - Street 1:3033 FANNIN ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-3258
Mailing Address - Country:US
Mailing Address - Phone:713-652-0011
Mailing Address - Fax:713-652-0015
Practice Address - Street 1:3033 FANNIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-3258
Practice Address - Country:US
Practice Address - Phone:713-652-0011
Practice Address - Fax:713-652-0015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00W258Medicare ID - Type UnspecifiedREHAB FACILITY