Healthcare Provider Details

I. General information

NPI: 1811009905
Provider Name (Legal Business Name): PCSC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7831 HIGHLAND ARBOR DR
HOUSTON TX
77070-4351
US

IV. Provider business mailing address

PO BOX 691827
HOUSTON TX
77269-1827
US

V. Phone/Fax

Practice location:
  • Phone: 281-807-5535
  • Fax: 281-807-1242
Mailing address:
  • Phone: 281-807-5535
  • Fax: 281-807-1242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number0090596
License Number StateTX

VIII. Authorized Official

Name: MR. CORY A CLARK
Title or Position: PRESIDENT/CEO
Credential:
Phone: 281-807-5535