Provider Demographics
NPI:1801131099
Name:FAMILY MEDICINE MMC PA
Entity type:Organization
Organization Name:FAMILY MEDICINE MMC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MEJIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-452-2299
Mailing Address - Street 1:6750 E SAM HOUSTON PKWY N
Mailing Address - Street 2:STE 100
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77049-4041
Mailing Address - Country:US
Mailing Address - Phone:281-452-2299
Mailing Address - Fax:281-452-2298
Practice Address - Street 1:6750 E SAM HOUSTON PKWY N
Practice Address - Street 2:STE 100
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77049-4041
Practice Address - Country:US
Practice Address - Phone:281-452-2299
Practice Address - Fax:281-452-2298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-29
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty