Provider Demographics
NPI:1083254577
Name:TOTALCARE2U FORT BEND BRAZORIA LLC
Entity Type:Organization
Organization Name:TOTALCARE2U FORT BEND BRAZORIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:THAO
Authorized Official - Middle Name:
Authorized Official - Last Name:HO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-868-2528
Mailing Address - Street 1:4714 FM 1488 RD STE 132
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77384-4930
Mailing Address - Country:US
Mailing Address - Phone:877-868-2528
Mailing Address - Fax:
Practice Address - Street 1:4714 FM 1488 RD STE 132
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77384-4930
Practice Address - Country:US
Practice Address - Phone:877-868-2528
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-13
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty