Provider Demographics
NPI:1548214950
Name:THE CENTER FOR FAMILY MEDICINE,WELLNESS & AESTHETICS P.A.
Entity Type:Organization
Organization Name:THE CENTER FOR FAMILY MEDICINE,WELLNESS & AESTHETICS P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHOK
Authorized Official - Middle Name:
Authorized Official - Last Name:TRIPATHY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-235-8348
Mailing Address - Street 1:3202 ACORN WOOD WAY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77059-3174
Mailing Address - Country:US
Mailing Address - Phone:281-488-8949
Mailing Address - Fax:
Practice Address - Street 1:350 N TEXAS AVE
Practice Address - Street 2:SUITE D
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4959
Practice Address - Country:US
Practice Address - Phone:281-827-1973
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH8554261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00W631Medicare PIN
TXE92365Medicare UPIN