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General NPI Number Information
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NPI Number | 1144624545
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Entity Type | Organization
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Legal Business Name | MED-AID HEALTH GROUP INC
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Dates
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Enumeration Date | 10/14/2014
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Last Update Date | 10/14/2014
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Provider Practice Location Address
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Address Line | 11251 RICHMOND AVE SUITE # F100A
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City | HOUSTON
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State | TX
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Zip | 77082-6658
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Country | US
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Telephone | 832-243-5494
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Fax | 832-243-5555
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Provider Business Mailing Address
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Address Line | 11251 RICHMOND AVE SUITE # F100A
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City | HOUSTON
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State | TX
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Zip | 77082-6658
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Country | US
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Telephone | 832-243-5494
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Fax | 832-243-5555
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Authorized Official
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Title or Position | CEO
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Name | MR. ALEXEY A. KHARITONOV
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Credential |
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Telephone | 832-243-5494
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery 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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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