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General NPI Number Information
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NPI Number | 1205186780
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Entity Type | Organization
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Legal Business Name | CARTER B INVESTMENT INC DBA FUQUA MEDICAL GROUP
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Dates
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Enumeration Date | 09/12/2012
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Last Update Date | 09/12/2012
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Provider Practice Location Address
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Address Line | 12559 GULF FREEWAY
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City | HOUSTON
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State | TX
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Zip | 77034-4509
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Country | US
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Telephone | 281-484-3844
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Fax | 281-484-3880
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Provider Business Mailing Address
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Address Line | 2525 S VOSS RD APT 364
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City | HOUSTON
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State | TX
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Zip | 77057-4434
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Country | US
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Telephone | 281-484-3844
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. CLAUDE E COX II
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Credential |
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Telephone | 281-484-3844
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 687034
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License Number State | TX
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