Provider Demographics
NPI:1144624545
Name:MED-AID HEALTH GROUP INC
Entity type:Organization
Organization Name:MED-AID HEALTH GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEXEY
Authorized Official - Middle Name:A
Authorized Official - Last Name:KHARITONOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-243-5494
Mailing Address - Street 1:11251 RICHMOND AVE
Mailing Address - Street 2:SUITE # F100A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-6658
Mailing Address - Country:US
Mailing Address - Phone:832-243-5494
Mailing Address - Fax:832-243-5555
Practice Address - Street 1:11251 RICHMOND AVE
Practice Address - Street 2:SUITE # F100A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-6658
Practice Address - Country:US
Practice Address - Phone:832-243-5494
Practice Address - Fax:832-243-5555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-14
Last Update Date:2014-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty