Provider Demographics
NPI:1558989814
Name:NEW LIFE DIRECT PRIMARY CARE PLLC
Entity Type:Organization
Organization Name:NEW LIFE DIRECT PRIMARY CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ESTHER
Authorized Official - Middle Name:
Authorized Official - Last Name:KHATIBI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-932-3677
Mailing Address - Street 1:5920 SARATOGA BLVD STE 450
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-4124
Mailing Address - Country:US
Mailing Address - Phone:773-932-3677
Mailing Address - Fax:
Practice Address - Street 1:5920 SARATOGA BLVD STE 450
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-4124
Practice Address - Country:US
Practice Address - Phone:361-236-2156
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-13
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care