Provider Demographics
NPI:1457065781
Name:JB PRIMARY HEALTH CARE CENTER INC
Entity type:Organization
Organization Name:JB PRIMARY HEALTH CARE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MABATAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-400-5450
Mailing Address - Street 1:8300 HOMESTEAD RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77028-2145
Mailing Address - Country:US
Mailing Address - Phone:972-400-5450
Mailing Address - Fax:
Practice Address - Street 1:8300 HOMESTEAD RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77028-2145
Practice Address - Country:US
Practice Address - Phone:972-400-5450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-11
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty