Provider Demographics
NPI:1841233194
Name:PRIMARY HEALTH NETWORK OF SOUTH TEXAS
Entity type:Organization
Organization Name:PRIMARY HEALTH NETWORK OF SOUTH TEXAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-383-9605
Mailing Address - Street 1:PO BOX 403856
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-0001
Mailing Address - Country:US
Mailing Address - Phone:615-373-7600
Mailing Address - Fax:615-373-7651
Practice Address - Street 1:1804 FM 646 RD W
Practice Address - Street 2:SUITE J
Practice Address - City:DICKINSON
Practice Address - State:TX
Practice Address - Zip Code:77539-3232
Practice Address - Country:US
Practice Address - Phone:281-534-0400
Practice Address - Fax:281-534-0440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty