Provisioncare Medical
NPI #1144884826 in Humble, Texas
Provider Information
- NPI Number
- 1144884826
- Entity Type
- Organization
- Organization Name
- Provisioncare Medical
- Primary Specialty
- Family Medicine
- Enumeration Date
- Apr 28, 2019
- Last Updated
- Jun 11, 2019
Practice Location
Authorized Official
- Name
- MR. DERRICK TRAYLOR
- Title
- CEO
- Phone
- (503) 901-5733
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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