Healthcare Provider Details

I. General information

NPI: 1477007466
Provider Name (Legal Business Name): 1488 INFUSION CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2016
Last Update Date: 11/07/2019
Certification Date:
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 132285
SPRING TX
77393-2285
US

V. Phone/Fax

Practice location:
  • Phone: 832-813-8932
  • Fax: 888-883-9901
Mailing address:
  • Phone: 832-813-8280
  • Fax: 800-500-2344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number StateTX

VIII. Authorized Official

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