Provider Demographics
NPI:1376953687
Name:FERONIA MEDICAL CLINIC INC
Entity Type:Organization
Organization Name:FERONIA MEDICAL CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MONIQUE
Authorized Official - Middle Name:M
Authorized Official - Last Name:NOTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-831-6029
Mailing Address - Street 1:6201 BONHOMME RD
Mailing Address - Street 2:SUITE # 472S
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-4385
Mailing Address - Country:US
Mailing Address - Phone:832-831-6029
Mailing Address - Fax:832-831-6248
Practice Address - Street 1:6201 BONHOMME RD
Practice Address - Street 2:SUITE # 472S
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-4385
Practice Address - Country:US
Practice Address - Phone:832-831-6029
Practice Address - Fax:832-831-6248
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-08
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty