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General NPI Number Information
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NPI Number | 1013461557
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Entity Type | Organization
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Legal Business Name | OUR PERFECT HANDS
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Dates
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Enumeration Date | 08/13/2016
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Last Update Date | 08/13/2016
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Provider Practice Location Address
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Address Line | 2020 PLANTATION DR APT 612
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City | CONROE
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State | TX
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Zip | 77301-1019
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Country | US
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Telephone | 936-217-8758
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Fax |
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Provider Business Mailing Address
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Address Line | 2020 PLANTATION DR APT 612
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City | CONROE
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State | TX
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Zip | 77301-1019
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Country | US
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Telephone | 936-217-8758
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | CARROL JOSEPH
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Credential |
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Telephone | 936-217-8758
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number | 201603706
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License Number State | TX
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