Provider Demographics
NPI:1457729204
Name:REFORM HEALTHCARE MANAGEMENT LTD
Entity Type:Organization
Organization Name:REFORM HEALTHCARE MANAGEMENT LTD
Other - Org Name:EDGEWATER CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KASHIF
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-565-2087
Mailing Address - Street 1:3030 EDGEWATER BLVD
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4438
Mailing Address - Country:US
Mailing Address - Phone:281-565-2087
Mailing Address - Fax:281-265-3412
Practice Address - Street 1:3030 EDGEWATER BLVD
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4438
Practice Address - Country:US
Practice Address - Phone:281-565-2087
Practice Address - Fax:281-265-3412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-10
Last Update Date:2015-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty