Provider Demographics
NPI:1023604246
Name:OPTIMUM PHYSICIANS HEALTHCARE PLLC
Entity type:Organization
Organization Name:OPTIMUM PHYSICIANS HEALTHCARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:MCINTYRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-993-4109
Mailing Address - Street 1:1819 BROADWAY ST STE 101
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-5671
Mailing Address - Country:US
Mailing Address - Phone:281-993-4109
Mailing Address - Fax:877-781-6179
Practice Address - Street 1:14690 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-7518
Practice Address - Country:US
Practice Address - Phone:281-531-7465
Practice Address - Fax:877-781-6179
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OPTIMUM PHYSICIANS HEALTHCARE PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-12-13
Last Update Date:2020-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care