Healthcare Provider Details
I. General information
NPI: 1912314543
Provider Name (Legal Business Name): MESSER MHT LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/15/2014
Last Update Date: 01/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
711 W SIDNOR ST
ALVIN TX
77511-2168
US
IV. Provider business mailing address
1515 HERITAGE DRIVE SUITE 110
MCKINNEY TX
75069-3379
US
V. Phone/Fax
- Phone: 281-331-5933
- Fax:
- Phone: 855-860-2109
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | D2740 |
| License Number State | TX |
VIII. Authorized Official
Name:
DALE
MESSER
Title or Position: OWNER
Credential: MD
Phone: 281-331-5933