Provider Demographics
NPI:1699891077
Name:TEXAS FAMILY GERIATRIC CLINIC, INC.
Entity type:Organization
Organization Name:TEXAS FAMILY GERIATRIC CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MUHAMMED
Authorized Official - Middle Name:N
Authorized Official - Last Name:AKHTAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-468-2358
Mailing Address - Street 1:12000 RICHMOND AVE STE 265
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-2431
Mailing Address - Country:US
Mailing Address - Phone:713-515-3477
Mailing Address - Fax:713-468-2595
Practice Address - Street 1:12121 RICHMOND AVE STE NO226
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-2432
Practice Address - Country:US
Practice Address - Phone:713-515-3477
Practice Address - Fax:713-468-2595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM0999207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXI4712Medicare UPIN