Provider Demographics
NPI:1598279200
Name:HOUSTON PRIMARY CARE PHYSICIANS LLC
Entity Type:Organization
Organization Name:HOUSTON PRIMARY CARE PHYSICIANS LLC
Other - Org Name:HOUSTON FAMILY CARE AT PERRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT / CFO
Authorized Official - Prefix:MR
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 1:1601 WATSON BLVD
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31093-3431
Mailing Address - Country:US
Mailing Address - Phone:478-975-6004
Mailing Address - Fax:
Practice Address - Street 1:1057 MORNINGSIDE DR
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:GA
Practice Address - Zip Code:31069-2903
Practice Address - Country:US
Practice Address - Phone:478-218-1801
Practice Address - Fax:478-218-1808
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOUSTON PRIMARY CARE PHYSICIANS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-11-17
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty