Provider Demographics
NPI:1316005838
Name:MEDICAL CENTER ASSOCIATES OF HOUSTON, LLP
Entity Type:Organization
Organization Name:MEDICAL CENTER ASSOCIATES OF HOUSTON, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LUBNA
Authorized Official - Middle Name:S
Authorized Official - Last Name:KAZIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-426-9104
Mailing Address - Street 1:6624 FANNIN ST
Mailing Address - Street 2:SUITE 1730
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2312
Mailing Address - Country:US
Mailing Address - Phone:713-790-8025
Mailing Address - Fax:713-426-9102
Practice Address - Street 1:6624 FANNIN ST
Practice Address - Street 2:SUITE 1730
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2312
Practice Address - Country:US
Practice Address - Phone:713-790-8025
Practice Address - Fax:713-790-8096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX172559001Medicaid
TX00166YMedicare ID - Type UnspecifiedGROUP PROVIDER NUMBER
TX172559001Medicaid