Healthcare Provider Details

I. General information

NPI: 1295978690
Provider Name (Legal Business Name): RLS MEDIC HEALTH SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2009
Last Update Date: 04/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7447 HARWIN DR
HOUSTON TX
77036-2016
US

IV. Provider business mailing address

7447 HARWIN DR
HOUSTON TX
77036-2016
US

V. Phone/Fax

Practice location:
  • Phone: 832-452-1968
  • Fax:
Mailing address:
  • Phone: 832-452-1968
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number15115478
License Number StateTX

VIII. Authorized Official

Name: MISS ROSALIND LEE STOTTS
Title or Position: HEALTH SERVICE PROVIDER
Credential:
Phone: 832-452-1968