1790850691 NPI number — FORT BEND FAMILY HEALTH CENTER, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790850691 NPI number — FORT BEND FAMILY HEALTH CENTER, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FORT BEND FAMILY HEALTH CENTER, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1790850691
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
400 AUSTIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RICHMOND
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77469-4406
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-342-4530
Provider Business Mailing Address Fax Number:
281-342-3832

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
REDA BLAND EVANS AT O.J. BAKER STREET
Provider Second Line Business Practice Location Address:
OWEN FRANKLIN HEALTH CTR, 2ND FL., PRAIRIE VIEW A&M
Provider Business Practice Location Address City Name:
PRAIRIE VIEW
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77446
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
936-857-2726
Provider Business Practice Location Address Fax Number:
936-857-2725
Provider Enumeration Date:
11/24/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BIBLE
Authorized Official First Name:
LYNDA
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
281-633-3106

Provider Taxonomy Codes

  • Taxonomy code: 261QF0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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