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General NPI Number Information
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NPI Number | 1164805974
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Entity Type | Organization
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Legal Business Name | ADS DOCTORS HOME VISIT, PLLC
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Dates
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Enumeration Date | 06/30/2015
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Last Update Date | 05/21/2018
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Provider Practice Location Address
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Address Line | 429 SHADY OAKS DR
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City | MURPHY
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State | TX
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Zip | 75094-4469
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Country | US
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Telephone | 518-894-2473
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Fax | 972-509-8923
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Provider Business Mailing Address
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Address Line | 123 POST CREST DR
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City | MURPHY
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State | TX
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Zip | 75094
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Country | US
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Telephone | 800-778-9040
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Fax | 800-445-8303
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Authorized Official
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Title or Position | OWNER
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Name | JOHN MELCHOR BRILLANTES CUA
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Credential |
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Telephone | 972-302-7642
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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