Provider Demographics
NPI:1306005780
Name:SERENITY FAMILY MEDICINE
Entity type:Organization
Organization Name:SERENITY FAMILY MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CECILIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:MCKEOWN-BIAGAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-337-8080
Mailing Address - Street 1:7322 SOUTHWEST FWY STE 550
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-2097
Mailing Address - Country:US
Mailing Address - Phone:713-337-8080
Mailing Address - Fax:713-337-8081
Practice Address - Street 1:7322 SOUTHWEST FWY STE 550
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-2097
Practice Address - Country:US
Practice Address - Phone:713-337-8080
Practice Address - Fax:713-337-8081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-02
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0A0302Medicare UPIN