Provider Demographics
NPI:1760140313
Name:AGP FAMILY HEALTH CLINIC CORP
Entity Type:Organization
Organization Name:AGP FAMILY HEALTH CLINIC CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:PEDROZA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-684-3909
Mailing Address - Street 1:11007 NORTHPOINTE BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-1683
Mailing Address - Country:US
Mailing Address - Phone:832-684-3909
Mailing Address - Fax:
Practice Address - Street 1:11007 NORTHPOINTE BLVD STE D
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-1683
Practice Address - Country:US
Practice Address - Phone:832-684-3909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-01
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty