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General NPI Number Information
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NPI Number | 1023366069
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Entity Type | Organization
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Legal Business Name | 1800TELEMEDCOM INC
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Dates
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Enumeration Date | 08/23/2012
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Last Update Date | 10/11/2012
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Provider Practice Location Address
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Address Line | 5815 AIRLINE DR SUITE A
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City | HOUSTON
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State | TX
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Zip | 77076-4922
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Country | US
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Telephone | 713-691-7770
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Fax | 800-520-4166
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Provider Business Mailing Address
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Address Line | 5815 AIRLINE DR SUITE A
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City | HOUSTON
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State | TX
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Zip | 77076-4922
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Country | US
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Telephone | 713-691-7770
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Fax | 800-520-4166
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Authorized Official
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Title or Position | C.E.O.
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Name | MRS. MARIA BIBBS
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Credential |
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Telephone | 713-691-7770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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