Provider Demographics
NPI:1669697694
Name:PRIMARY HEALTH NETWORK OF SOUTH TEXAS
Entity type:Organization
Organization Name:PRIMARY HEALTH NETWORK OF SOUTH TEXAS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:MR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-365-0013
Mailing Address - Street 1:8830 LONG POINT RD
Mailing Address - Street 2:SUITE 504
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8830 LONG POINT RD
Practice Address - Street 2:SUITE 504
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055
Practice Address - Country:US
Practice Address - Phone:713-365-0013
Practice Address - Fax:713-365-0014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty