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General NPI Number Information
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NPI Number | 1124679907
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Entity Type | Organization
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Legal Business Name | PRECISION WAVE RECOVERY LP
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Dates
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Enumeration Date | 09/24/2019
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Last Update Date | 09/24/2019
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Provider Practice Location Address
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Address Line | 7700 MAIN ST STE 365
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City | HOUSTON
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State | TX
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Zip | 77030-4456
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Country | US
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Telephone | 832-384-4106
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Fax | 713-943-2225
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Provider Business Mailing Address
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Address Line | 7220 W JEFFERSON AVE
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City | LAKEWOOD
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State | CO
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Zip | 80235-2031
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Country | US
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Telephone | 303-922-4636
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Fax | 303-922-4640
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Authorized Official
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Title or Position | GENERAL PARTNER
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Name | MR. CALVIN PARKS JR.
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Credential | CEO
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Telephone | 229-291-7287
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204R00000X
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Taxonomy Name | Electrodiagnostic Medicine Physician
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License Number |
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License Number State |
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