Healthcare Provider Details

I. General information

NPI: 1649744871
Provider Name (Legal Business Name): MEDIFUSE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2019
Last Update Date: 01/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1235 CLEAR LAKE CITY BLVD STE E
HOUSTON TX
77062-8125
US

IV. Provider business mailing address

2203 TIMBERLOCH PL STE 132
SPRING TX
77380-1105
US

V. Phone/Fax

Practice location:
  • Phone: 281-305-0983
  • Fax: 888-883-9901
Mailing address:
  • Phone: 832-813-8280
  • Fax: 800-500-2344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: STEVE ROPHAIL
Title or Position: MANAGING MEMBER
Credential:
Phone: 713-679-4487