1487175360 NPI number — MEMORIAL RELATIONSHIPS & COUPLES CENTER, PLLC.

Table of content: (NPI 1487175360)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487175360 NPI number — MEMORIAL RELATIONSHIPS & COUPLES CENTER, PLLC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MEMORIAL RELATIONSHIPS & COUPLES CENTER, PLLC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1487175360
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/30/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
955 DAIRY ASHFORD RD
Provider Second Line Business Mailing Address:
SUITE 108
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77079
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
832-407-0487
Provider Business Mailing Address Fax Number:
832-243-4585

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
955 DAIRY ASHFORD RD
Provider Second Line Business Practice Location Address:
SUITE 108
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77079
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
832-407-0487
Provider Business Practice Location Address Fax Number:
832-243-4585
Provider Enumeration Date:
06/30/2017

Additional Information

Authorized Official

Authorized Official Last Name:
THARP
Authorized Official First Name:
ROCIO
Authorized Official Middle Name:
J.
Authorized Official Title or Position:
OWNER/CEO
Authorized Official Telephone Number:
832-407-0487

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  65974 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101Y00000X , with the licence number: 201402 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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