Provider Demographics
NPI:1811079205
Name:A-1 FAMILY HEALTHCENTER P.A.
Entity type:Organization
Organization Name:A-1 FAMILY HEALTHCENTER P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ABLA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOUKKARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-427-6363
Mailing Address - Street 1:PO BOX 690
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77522-0690
Mailing Address - Country:US
Mailing Address - Phone:281-427-6363
Mailing Address - Fax:281-420-6867
Practice Address - Street 1:2610 N ALEXANDER DR STE 201
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77520-3399
Practice Address - Country:US
Practice Address - Phone:281-427-6363
Practice Address - Fax:281-420-6867
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK6602170100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical GeneticsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXA94893Medicare UPIN