Provider Demographics
NPI:1497430128
Name:KINGSPOINT HOME VISITING PHYSICIANS LLC
Entity Type:Organization
Organization Name:KINGSPOINT HOME VISITING PHYSICIANS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BERTRAND
Authorized Official - Middle Name:K
Authorized Official - Last Name:EBANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-774-1330
Mailing Address - Street 1:10 SANTA CLARITA CIR
Mailing Address - Street 2:
Mailing Address - City:MANVEL
Mailing Address - State:TX
Mailing Address - Zip Code:77578-3352
Mailing Address - Country:US
Mailing Address - Phone:832-774-1330
Mailing Address - Fax:
Practice Address - Street 1:14200 GULF FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77034-5369
Practice Address - Country:US
Practice Address - Phone:832-774-1330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-20
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty