Space Center Ipa PA

NPI #1891900981 in Santa Fe, Texas

Provider Information

NPI Number: 1891900981
Entity Type: Organization
Organization Name: Space Center Ipa PA
Primary Specialty: General Practice
Enumeration Date: May 11, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 12902 CLOUD DR
City: Santa Fe
State: Texas
ZIP Code: 77510-9345
Phone: (409) 316-1928

Authorized Official

Name: JOE E POUZAR, MD
Title: PRESIDENT
Phone: (409) 316-1928

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
General Practice	208D00000X	Primary

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