NUPHYSICIA HEALTH OF TEXAS
Medical Practice at Southwest Fwy, Houston, TX

License number
Texas G2256
Category
Medical Practice
Type
Community Health Worker
Owner
Name: DR. OSCAR WILLIAM BOULTINGHOUSE M.D.
Title: MEDICAL DIRECTOR
Phone: (713) 358-9271
Address
Address
4625 Southwest Fwy SOUTHWEST SUITE 142, Houston, TX 77027
National Provider ID: 1629524376
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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NUPHYSICIA SERVICES, PA

4625 SW Fwy STE 142, Houston, TX 77027

Doing business as:
NUPHYSICIA HEALTH OF TEXAS<br>NUPHYSICIA, INC<br>NUPHYSICIA PROVIDER NETWORKS, PA<br>Nuphysicia Services, PA<br>Nuphysicia, LLC
Registration:
Jan 23, 2012
State ID:
0801539251
Business type:
Foreign Professional Association
Entity State:
NM
Managers:
Glenn G Hammack (SECRETARY, PRESIDENT, Director, Secretary, Member, President), 4625 SW Fwy STE 142, Houston, TX 77027
4625 SW Fwy, Houston, TX 77027,Michael J Davis (TREASURER, DIRECTOR, Director, Treasurer, Vice-President), 4625 SW Fwy STE 142, Houston, TX 77027
4625 SW Fwy, Houston, TX 77027,Oscar W Boultinghouse (DIRECTOR, Director, President, Vice-President), 4625 SW Fwy STE 142, Houston, TX 77027
4625 SW Fwy, Houston, TX 77027,...
TIN:
32046675867

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