Provider Demographics
NPI:1205394301
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:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LONIE
Authorized Official - Middle Name:
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:832-724-7201
Mailing Address - Fax:281-980-6207
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:832-724-7201
Practice Address - Fax:281-980-6207
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DOWNTOWN PERFORMANCE MEDICAL CENTER, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-03-07
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty