Provider Demographics
NPI:1407676547
Name:GREATER HOUSTON FAMILY PRACTICE LLC
Entity type:Organization
Organization Name:GREATER HOUSTON FAMILY PRACTICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAIMOONA
Authorized Official - Middle Name:Q
Authorized Official - Last Name:NIZAMI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:463-306-8563
Mailing Address - Street 1:PO BOX 540088
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77254-0088
Mailing Address - Country:US
Mailing Address - Phone:713-950-1190
Mailing Address - Fax:713-950-1327
Practice Address - Street 1:320 KINGWOOD EXECUTIVE DR STE B
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-2769
Practice Address - Country:US
Practice Address - Phone:346-330-6856
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-14
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty