Provider Demographics
NPI:1619175056
Name:DAIRY ASHFORD FAMILY PRACTICE ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:DAIRY ASHFORD FAMILY PRACTICE ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:J
Authorized Official - Last Name:CAUSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-759-0200
Mailing Address - Street 1:1500 S DAIRY ASHFORD ST STE 198
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-3858
Mailing Address - Country:US
Mailing Address - Phone:281-759-0200
Mailing Address - Fax:281-759-4715
Practice Address - Street 1:1500 S DAIRY ASHFORD ST STE 198
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-3858
Practice Address - Country:US
Practice Address - Phone:281-759-0200
Practice Address - Fax:281-759-4715
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care