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NPI Code Detail

MEDICARE: XPLOSION TECHNOLOGY CORPORATION

MEDICARE: XPLOSION TECHNOLOGY CORPORATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133N00000XNutritionist
2163W00000XRegistered Nurse
3171M00000XCase Manager/Care Coordinator
4174H00000XHealth Educator
5208D00000XGeneral Practice Physician
6364S00000XClinical Nurse Specialist
7207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1699573733
Entity Type Code : Organization
Provider Name (Legal Business Name) : XPLOSION TECHNOLOGY CORPORATION
Provider Business Mailing Address
First Line : 1803 AMBASSADOR CT
Second Line :
City : MISSOURI CITY
State : TX
Zip : 77459-3758
Country : US
Telephone Number : 832-969-3686
Fax Number :
Provider Business Practice Location Address
First Line : 1803 AMBASSADOR CT
Second Line :
City : MISSOURI CITY
State : TX
Zip : 77459-3758
Country : US
Telephone Number : 832-969-3686
Fax Number :
Authorized Official
Title or Position : COO
Name : ISIS ASHFORD
Credential :
Telephone Number : 832-969-3686
Provider Enumeration Date : 03/05/2025
Last Update Date : 03/05/2025

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Directions to “XPLOSION TECHNOLOGY CORPORATION ” Practice Location

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