Provider Demographics
NPI:1891213633
Name:PRIME PHYSICIANS PA
Entity Type:Organization
Organization Name:PRIME PHYSICIANS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MINH
Authorized Official - Middle Name:
Authorized Official - Last Name:MAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-730-8455
Mailing Address - Street 1:13480 VETERANS MEMORIAL DR STE R1
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77014-1670
Mailing Address - Country:US
Mailing Address - Phone:281-587-1600
Mailing Address - Fax:281-587-1601
Practice Address - Street 1:13480 VETERANS MEMORIAL DR STE R1
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77014-1670
Practice Address - Country:US
Practice Address - Phone:281-587-1600
Practice Address - Fax:281-587-1601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-31
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty