Healthcare Provider Details

I. General information

NPI: 1902298680
Provider Name (Legal Business Name): I.M. QUALITY ASSISTING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2015
Last Update Date: 03/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6361 KATY AV
PORT ARTHUR TX
77640
US

IV. Provider business mailing address

6361 KATY AV
PORT ARTHUR TX
77640
US

V. Phone/Fax

Practice location:
  • Phone: 409-293-2894
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name: CHRIS W HALE
Title or Position: FIRST ASSIST
Credential:
Phone: 409-293-2894