Provider Demographics
NPI:1811356769
Name:SOTERION KINGDOM PERSONAL AND FAMILY MANAGEMENT CENTER
Entity type:Organization
Organization Name:SOTERION KINGDOM PERSONAL AND FAMILY MANAGEMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:MBA,CPA
Authorized Official - Phone:281-882-9036
Mailing Address - Street 1:7401 GULF FWY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77017-1580
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9321 EDGEBROOK ST STE C
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77075-1249
Practice Address - Country:US
Practice Address - Phone:832-814-8301
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-21
Last Update Date:2016-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health