Provider Demographics
NPI:1649562430
Name:KETE HEALTH CENTER LLC
Entity Type:Organization
Organization Name:KETE HEALTH CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:OLZHAS
Authorized Official - Middle Name:
Authorized Official - Last Name:KETEBAYEV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-627-4919
Mailing Address - Street 1:3730 FM 1960 RD W
Mailing Address - Street 2:SUITE 108
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77068-3530
Mailing Address - Country:US
Mailing Address - Phone:281-627-4919
Mailing Address - Fax:
Practice Address - Street 1:3730 FM 1960 RD W
Practice Address - Street 2:SUITE 108
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77068-3530
Practice Address - Country:US
Practice Address - Phone:281-627-4919
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-11
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty