Provider Demographics
NPI:1548477805
Name:UNIVERSAL PHYSICIANS PA
Entity type:Organization
Organization Name:UNIVERSAL PHYSICIANS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LILY
Authorized Official - Middle Name:
Authorized Official - Last Name:LAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-893-3792
Mailing Address - Street 1:3711 BRIARPARK DR STE 202
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77042-5246
Mailing Address - Country:US
Mailing Address - Phone:713-893-3792
Mailing Address - Fax:713-391-8374
Practice Address - Street 1:3711 BRIARPARK DR STE 202
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042-5246
Practice Address - Country:US
Practice Address - Phone:713-893-3792
Practice Address - Fax:713-391-8374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX195781301Medicaid
TX00Y102Medicare PIN