1790871788 NPI number — MEDICAL INSIGHTS & CARE UNLIMITED, L.P.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790871788 NPI number — MEDICAL INSIGHTS & CARE UNLIMITED, L.P.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MEDICAL INSIGHTS & CARE UNLIMITED, L.P.
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:
1790871788
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/02/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 721350
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77272-1350
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-774-6428
Provider Business Mailing Address Fax Number:
713-774-3822

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4610 BELLE PARK
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77072
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-774-6428
Provider Business Practice Location Address Fax Number:
713-774-3822
Provider Enumeration Date:
10/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
DEVILLA
Authorized Official First Name:
LUCENA
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR/PRESIDENT
Authorized Official Telephone Number:
713-774-6428

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3747P1801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 0245375-01 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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