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General NPI Number Information
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NPI Number | 1245803840
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Entity Type | Organization
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Legal Business Name | PUSH MEDICAL SERVICES
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Dates
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Enumeration Date | 07/21/2021
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Last Update Date | 07/21/2021
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Provider Practice Location Address
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Address Line | 168 COL ETHEREDGE BLVD STE A
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City | HUNTSVILLE
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State | TX
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Zip | 77340-4224
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Country | US
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Telephone | 936-439-4608
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Fax | 936-353-0055
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Provider Business Mailing Address
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Address Line | 168 COL ETHEREDGE BLVD STE A
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City | HUNTSVILLE
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State | TX
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Zip | 77340-4224
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Country | US
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Telephone | 936-439-4608
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Fax | 936-353-0055
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | ARETHA HORTON
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Credential |
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Telephone | 832-392-5495
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) 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 | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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