Provider Demographics
NPI:1871335521
Name:CLINICA CENTRO MEDICO FAMILIAR INC
Entity type:Organization
Organization Name:CLINICA CENTRO MEDICO FAMILIAR INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:DARLYS
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVAREZ CAMPO
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:832-290-0016
Mailing Address - Street 1:4534 HIGHWAY 6 N
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-3402
Mailing Address - Country:US
Mailing Address - Phone:281-345-0008
Mailing Address - Fax:
Practice Address - Street 1:4534 HIGHWAY 6 N
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-3402
Practice Address - Country:US
Practice Address - Phone:281-345-0008
Practice Address - Fax:281-345-2299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-12
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty