Provider Demographics
NPI:1295053023
Name:CAL TEX MEDICAL MANAGEMENT ASSOCIATES, LLC
Entity type:Organization
Organization Name:CAL TEX MEDICAL MANAGEMENT ASSOCIATES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN ASSISTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:CAIN
Authorized Official - Suffix:JR
Authorized Official - Credentials:PA-C
Authorized Official - Phone:619-871-3252
Mailing Address - Street 1:P.O.BOX 299
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406
Mailing Address - Country:US
Mailing Address - Phone:713-589-1435
Mailing Address - Fax:713-589-1439
Practice Address - Street 1:908 E SOUTHMORE AVE STE 340
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77502-1133
Practice Address - Country:US
Practice Address - Phone:713-589-1435
Practice Address - Fax:713-589-1439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-04
Last Update Date:2010-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA04517261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center