Provider Demographics
NPI:1730719402
Name:MOMENTUM CARE SYSTEMS LLC
Entity type:Organization
Organization Name:MOMENTUM CARE SYSTEMS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:KNOTTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-752-0825
Mailing Address - Street 1:609 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-3167
Mailing Address - Country:US
Mailing Address - Phone:832-752-0825
Mailing Address - Fax:877-705-7277
Practice Address - Street 1:24020 HIGHWAY 59 N
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-1536
Practice Address - Country:US
Practice Address - Phone:832-752-0825
Practice Address - Fax:877-705-7277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-22
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty