Provider Demographics
NPI:1952416687
Name:DOCTORS' SERVICES FOUNDATION, INC.
Entity Type:Organization
Organization Name:DOCTORS' SERVICES FOUNDATION, INC.
Other - Org Name:COMMUNITY CLINIC AKA AIRLINE FAMILY MEDICINE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:AVRUM
Authorized Official - Middle Name:M
Authorized Official - Last Name:STEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:713-695-4013
Mailing Address - Street 1:5808 AIRLINE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77076-4923
Mailing Address - Country:US
Mailing Address - Phone:713-695-4013
Mailing Address - Fax:713-695-6929
Practice Address - Street 1:5808 AIRLINE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77076-4923
Practice Address - Country:US
Practice Address - Phone:713-695-4013
Practice Address - Fax:713-695-6929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX093846601Medicaid
TX00RM28OtherBCBS
TX00RM28OtherBCBS