Provider Demographics
NPI:1861786782
Name:S.E. COMPLETE FAMILY CARE
Entity type:Organization
Organization Name:S.E. COMPLETE FAMILY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR/CLINIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:TRIPTESH
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:CHAUDHURI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-501-0179
Mailing Address - Street 1:1907 SOUTHMORE AVE # 5
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77502-1314
Mailing Address - Country:US
Mailing Address - Phone:281-501-0179
Mailing Address - Fax:281-501-0183
Practice Address - Street 1:1907 SOUTHMORE AVE # 5
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77502-1314
Practice Address - Country:US
Practice Address - Phone:281-501-0179
Practice Address - Fax:281-501-0183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-08
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care