Healthcare Provider Details

I. General information

NPI: 1316526700
Provider Name (Legal Business Name): SELECT INFUSION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2021
Last Update Date: 04/05/2021
Certification Date: 04/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 VISION PARK BLVD STE 102
SHENANDOAH TX
77384-3008
US

IV. Provider business mailing address

PO BOX 130816
SPRING TX
77393-0816
US

V. Phone/Fax

Practice location:
  • Phone: 281-903-6009
  • Fax: 888-883-9901
Mailing address:
  • Phone: 281-903-6009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: STEVE ROPHAIL
Title or Position: MANAGING MEMBER
Credential:
Phone: 713-679-4487