Provider Demographics
NPI:1992255939
Name:HUMBLE FAMILY PRACTICE, PLLC
Entity type:Organization
Organization Name:HUMBLE FAMILY PRACTICE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRED MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:CAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-446-1520
Mailing Address - Street 1:18652 MCKAY DR STE 100
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-5716
Mailing Address - Country:US
Mailing Address - Phone:281-446-1520
Mailing Address - Fax:281-446-0838
Practice Address - Street 1:18652 MCKAY DR
Practice Address - Street 2:SUITE 100
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-5716
Practice Address - Country:US
Practice Address - Phone:281-446-1520
Practice Address - Fax:281-446-0838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-13
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty