Provider Demographics
NPI:1952898249
Name:FOYE MD MEDICAL SPA, WELLNESS & PRIMARY CARE CLINIC, LLC
Entity Type:Organization
Organization Name:FOYE MD MEDICAL SPA, WELLNESS & PRIMARY CARE CLINIC, LLC
Other - Org Name:FOYE MD AND SPA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:FOYEKE
Authorized Official - Middle Name:ADEYEMO
Authorized Official - Last Name:IKYAATOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-930-1705
Mailing Address - Street 1:20702 BENDING PINES LN
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-2782
Mailing Address - Country:US
Mailing Address - Phone:832-930-1705
Mailing Address - Fax:832-604-6291
Practice Address - Street 1:3800 N SHEPHERD DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77018-6400
Practice Address - Country:US
Practice Address - Phone:832-930-1705
Practice Address - Fax:832-742-9896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-23
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP1956207Q00000X, 261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty