Providence Mission Ministry LLC

NPI #1366988412 in Coldspring, Texas

Provider Information

NPI Number: 1366988412
Entity Type: Organization
Organization Name: Providence Mission Ministry LLC
Primary Specialty: Clinic/Center - Primary Care
Enumeration Date: Jan 12, 2017
Last Updated: Mar 8, 2020

Practice Location

Address: 21 ALPINE ST
City: Coldspring
State: Texas
ZIP Code: 77331-8058
Phone: (936) 647-2227

Authorized Official

Name: MRS. JENNIFER NGUYEN
Title: BUSINESS ACCOUNT MANAGER
Phone: (281) 774-8785

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Primary Care — Primary Care	261QP2300X	Primary

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