Healthcare Provider Details
I. General information
NPI: 1871989459
Provider Name (Legal Business Name): SOUTH TEXAS COST CONTAINMENT OF ALICE, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/10/2015
Last Update Date: 04/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
102 E MAIN ST
ALICE TX
78332-4963
US
IV. Provider business mailing address
12600 NORTHBOROUGH DR SUITE 300
HOUSTON TX
77067
US
V. Phone/Fax
- Phone: 361-664-6504
- Fax: 361-664-6531
- Phone: 281-673-2466
- Fax: 713-972-3420
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QX0100X |
| Taxonomy | Occupational Medicine Clinic/Center |
| License Number | |
| License Number State | TX |
VIII. Authorized Official
Name: DR.
WILLIAM
OLIVER
LEE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 281-482-5551