Healthcare Provider Details
I. General information
NPI: 1184918500
Provider Name (Legal Business Name): JMV SURGERY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/02/2011
Last Update Date: 06/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1475 FM 1960 BYPASS RD E
HUMBLE TX
77338-3909
US
IV. Provider business mailing address
18955 N MEMORIAL DR STE 320
HUMBLE TX
77338-4263
US
V. Phone/Fax
- Phone: 713-532-7311
- Fax:
- Phone: 713-532-7311
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 282N00000X |
| Taxonomy | General Acute Care Hospital |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MONICA
PINEDA
Title or Position: ACCESS MANAGER
Credential:
Phone: 713-532-7311