Provisioncare Medical
Provisioncare Medical is a Family Medicine Physician in Humble, Texas. Registered with an NPI since 2019.
- In the registry since
- 2019
Practice location Address checks out
11501 N Sam Houston Pkwy E Ste AHumble, TX 77396-4635
Phone: (281) 652-5612
Fax: (346) 980-4054
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Family Medicine Physician (primary) | Taxonomy 207Q00000X |
|---|
Record details
| NPI number | 1144884826 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Derrick Traylor — Ceo · (503) 901-5733 |
| Other names | Mancavemd |
| NPI enumerated | April 28, 2019 |
| Last updated in NPPES | June 11, 2019 |
| Mailing address | 14700 Woodson Park Dr Apt 1512, Houston, TX 77044-4531 |
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