Healthcare Provider Details

I. General information

NPI: 1164406351
Provider Name (Legal Business Name): MRC TOWNCREEK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1115 AVENUE O
HUNTSVILLE TX
77340-4443
US

IV. Provider business mailing address

2202 TIMBERLOCH PL
THE WOODLANDS TX
77380-1177
US

V. Phone/Fax

Practice location:
  • Phone: 936-295-0216
  • Fax: 936-291-2907
Mailing address:
  • Phone: 281-363-2600
  • Fax: 281-292-6360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number010009
License Number StateTX

VIII. Authorized Official

Name: MR. RICHARD BERMAN
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 281-363-2600