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General NPI Number Information
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NPI Number | 1134125735
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Entity Type | Organization
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Legal Business Name | QUALITY INFUSION CARE
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Dates
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Enumeration Date | 06/28/2005
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Last Update Date | 05/19/2011
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Provider Practice Location Address
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Address Line | 6671 SOUTHWEST FREEWAY SUITE 777
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City | HOUSTON
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State | TX
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Zip | 77074
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Country | US
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Telephone | 214-692-6666
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Fax | 214-692-6670
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Provider Business Mailing Address
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Address Line | 5931 DESCO DR
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City | DALLAS
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State | TX
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Zip | 75225-1604
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Country | US
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Telephone | 214-692-6666
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Fax | 214-692-6670
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Authorized Official
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Title or Position | CEO
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Name | NAT E. MANGUM
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Credential |
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Telephone | 214-692-6666
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 45D0932241
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 16579
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number | 006488
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License Number State | TX
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