Provider Demographics
NPI:1700471851
Name:CLINICA FAMILIA HISPANA. INC
Entity Type:Organization
Organization Name:CLINICA FAMILIA HISPANA. INC
Other - Org Name:CLINICA FAMILIA HISPANA. INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:
Authorized Official - Last Name:DEL TORO BRAVO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:737-333-1263
Mailing Address - Street 1:4534 HWY 6 N.
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084
Mailing Address - Country:US
Mailing Address - Phone:281-974-1225
Mailing Address - Fax:281-501-1873
Practice Address - Street 1:5392 W 34TH ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77092-6626
Practice Address - Country:US
Practice Address - Phone:281-974-1225
Practice Address - Fax:281-501-1873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-01
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty