Provider Demographics
NPI:1932472453
Name:US PUBLIC HEALTH SERVICES
Entity Type:Organization
Organization Name:US PUBLIC HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT DIRECTOR FOR ICE HEALTH S
Authorized Official - Prefix:DR
Authorized Official - First Name:JON
Authorized Official - Middle Name:
Authorized Official - Last Name:KROHMER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-732-4600
Mailing Address - Street 1:15850 EXPORT PLAZA DRIVE
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77032
Mailing Address - Country:US
Mailing Address - Phone:281-985-8511
Mailing Address - Fax:
Practice Address - Street 1:15850 EXPORT PLAZA DRIVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77032
Practice Address - Country:US
Practice Address - Phone:281-985-8511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-14
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA 9103676261QP0904X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0904XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, Federal