Provider Demographics
NPI:1710250741
Name:DOWNTOWN PERFORMANCE MEDICAL CENTER, INC
Entity Type:Organization
Organization Name:DOWNTOWN PERFORMANCE MEDICAL CENTER, INC
Other - Org Name:HOUSTON MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LONIE
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-652-0011
Mailing Address - Street 1:3033 FANNIN ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-3258
Mailing Address - Country:US
Mailing Address - Phone:713-652-0011
Mailing Address - Fax:713-652-0015
Practice Address - Street 1:301 VISTA RD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77504-1490
Practice Address - Country:US
Practice Address - Phone:281-487-0280
Practice Address - Fax:281-980-6207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-22
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty