Provider Demographics
NPI:1083833180
Name:MEDPARTNERS INC
Entity Type:Organization
Organization Name:MEDPARTNERS INC
Other - Org Name:PERFORMANCE MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:R
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:713-777-8100
Mailing Address - Street 1:8449 W BELLFORT ST STE 140-A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77071-2245
Mailing Address - Country:US
Mailing Address - Phone:713-777-8100
Mailing Address - Fax:713-777-8103
Practice Address - Street 1:8449 W BELLFORT ST STE 140-A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77071-2245
Practice Address - Country:US
Practice Address - Phone:713-777-8100
Practice Address - Fax:713-777-8103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4469207R00000X
TXK-4469207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Not Answered207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00933ZMedicare ID - Type UnspecifiedGROUP NUMBER