1801153283 NPI number — MEDICAL STAFF MANAGEMENT, INC.

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 1801153283 NPI number — MEDICAL STAFF MANAGEMENT, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MEDICAL STAFF MANAGEMENT, INC.
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:
1801153283
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/30/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
111 W 2ND ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CAMERON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76520-3310
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-772-4160
Provider Business Mailing Address Fax Number:
254-697-4064

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
715 DISCOVERY BLVD STE 114
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CEDAR PARK
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78613-2295
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-402-7820
Provider Business Practice Location Address Fax Number:
512-402-7821
Provider Enumeration Date:
04/23/2012

Additional Information

Authorized Official

Authorized Official Last Name:
STANDARD
Authorized Official First Name:
TOMMY
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT/CEO
Authorized Official Telephone Number:
254-284-0047

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X , with the licence number:  00000 , 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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