Provider Demographics
NPI:1972299089
Name:KATY FAMILY MEDICINE AND URGENT CARE
Entity Type:Organization
Organization Name:KATY FAMILY MEDICINE AND URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:EKONG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:763-498-1452
Mailing Address - Street 1:1230 RYANN ROSE CREEK LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-4053
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:21922 BELLAIRE BLVD STE 600
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-3919
Practice Address - Country:US
Practice Address - Phone:832-402-6326
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-12
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care