Provider Demographics
NPI:1144747981
Name:FOUNDATION FOR LIFE
Entity Type:Organization
Organization Name:FOUNDATION FOR LIFE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:PONTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-682-5433
Mailing Address - Street 1:10900 NORTHWEST FWY STE 112
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77092-7309
Mailing Address - Country:US
Mailing Address - Phone:713-682-5433
Mailing Address - Fax:713-688-0174
Practice Address - Street 1:10900 NORTHWEST FWY STE 112
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77092-7309
Practice Address - Country:US
Practice Address - Phone:713-682-5433
Practice Address - Fax:713-688-0174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-23
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1144747981Medicaid