Healthcare Provider Details

I. General information

NPI: 1134747678
Provider Name (Legal Business Name): LOW FIFTY CONSTRUCTION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2020
Last Update Date: 08/05/2020
Certification Date: 08/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6201 JESSICA DR
CORPUS CHRISTI TX
78414-3667
US

IV. Provider business mailing address

3606 GRASSMERE DR
CORPUS CHRISTI TX
78415-3607
US

V. Phone/Fax

Practice location:
  • Phone: 361-765-5212
  • Fax: 361-334-6273
Mailing address:
  • Phone: 361-510-9372
  • Fax: 361-334-6273

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number State

VIII. Authorized Official

Name: MRS. NORMA DAISY GAMEZ
Title or Position: CLAIMS ADMINISTRATOR
Credential:
Phone: 361-510-9372