Healthcare Provider Details

I. General information

NPI: 1487095147
Provider Name (Legal Business Name): 1800TELEMEDCOM INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2013
Last Update Date: 07/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5815 AIRLINE DR SUITE A-1
HOUSTON TX
77076-4922
US

IV. Provider business mailing address

5815 AIRLINE DR SUITE A-1
HOUSTON TX
77076-4922
US

V. Phone/Fax

Practice location:
  • Phone: 713-691-7735
  • Fax: 866-924-6348
Mailing address:
  • Phone: 713-691-7735
  • Fax: 866-924-6348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number StateTX

VIII. Authorized Official

Name: MRS. MARIA B BIBBS
Title or Position: CEO ADMINISRATOR
Credential:
Phone: 713-691-7735