Healthcare Provider Details

I. General information

NPI: 1427289412
Provider Name (Legal Business Name): PRIME MEDIQUIP SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2009
Last Update Date: 07/08/2020
Certification Date: 07/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2620 CULLEN BLVD STE 202
PEARLAND TX
77581-9008
US

IV. Provider business mailing address

PO BOX 84268
PEARLAND TX
77584-0015
US

V. Phone/Fax

Practice location:
  • Phone: 281-412-0900
  • Fax: 281-412-4020
Mailing address:
  • Phone: 281-412-0900
  • Fax: 281-412-4020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSEPH M PEREZ
Title or Position: PRESIDENT
Credential:
Phone: 281-412-0900