Provider Demographics
NPI:1497335194
Name:HOUSTON PRIMARY CARE PHYSICIANS, LLC
Entity Type:Organization
Organization Name:HOUSTON PRIMARY CARE PHYSICIANS, LLC
Other - Org Name:HOUSTON FAMILY CARE AT BONAIRE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP/CFO
Authorized Official - Prefix:
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:WHILDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-542-7959
Mailing Address - Street 1:2510 GA HIGHWAY 127
Mailing Address - Street 2:
Mailing Address - City:KATHLEEN
Mailing Address - State:GA
Mailing Address - Zip Code:31047-2828
Mailing Address - Country:US
Mailing Address - Phone:478-352-7143
Mailing Address - Fax:478-352-7144
Practice Address - Street 1:2510 GA HIGHWAY 127
Practice Address - Street 2:
Practice Address - City:KATHLEEN
Practice Address - State:GA
Practice Address - Zip Code:31047-2828
Practice Address - Country:US
Practice Address - Phone:478-352-7143
Practice Address - Fax:478-352-7144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-08
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty