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General NPI Number Information
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NPI Number | 1215479142
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Entity Type | Organization
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Legal Business Name | WILCREST CPAP'S
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Dates
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Enumeration Date | 11/09/2016
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Last Update Date | 11/09/2016
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Provider Practice Location Address
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Address Line | 12000 WILCREST DR 204
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City | HOUSTON
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State | TX
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Zip | 77031-1924
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Country | US
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Telephone | 281-871-0104
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Fax | 832-813-5070
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Provider Business Mailing Address
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Address Line | 12000 WILCREST DR 204
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City | HOUSTON
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State | TX
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Zip | 77031-1924
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Country | US
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Telephone | 281-871-0104
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Fax | 832-847-8553
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JOSEPH FONGUM
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Credential |
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Telephone | 281-871-0104
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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