Healthcare Provider Details

I. General information

NPI: 1316191414
Provider Name (Legal Business Name): AMW MEDICAL CONSULTING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2008
Last Update Date: 11/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2685 HARRISON ST
BEAUMONT TX
77702-1201
US

IV. Provider business mailing address

PO BOX 1513
DEER PARK TX
77536-1513
US

V. Phone/Fax

Practice location:
  • Phone: 281-576-9000
  • Fax:
Mailing address:
  • Phone: 281-576-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code111NX0100X
TaxonomyOccupational Health Chiropractor
License Number9035
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code363LX0106X
TaxonomyOccupational Health Nurse Practitioner
License Number776723
License Number StateTX

VIII. Authorized Official

Name: CHRISTINA PEREZ
Title or Position: OWNER
Credential:
Phone: 409-892-7200