Provider Demographics
NPI:1376261164
Name:TESTMED-CLINIC LLC
Entity Type:Organization
Organization Name:TESTMED-CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:
Authorized Official - Last Name:AWAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-810-4615
Mailing Address - Street 1:12121 WESTHEIMER RD STE 120
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-6654
Mailing Address - Country:US
Mailing Address - Phone:832-810-4615
Mailing Address - Fax:832-810-4617
Practice Address - Street 1:12121 WESTHEIMER RD STE 120
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-6654
Practice Address - Country:US
Practice Address - Phone:832-810-4615
Practice Address - Fax:832-810-4617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-17
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care