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General NPI Number Information
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NPI Number | 1275785206
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Entity Type | Organization
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Legal Business Name | COMPLETE MED CARE ASSOCIATES AND TREATMENT CENTER
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Dates
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Enumeration Date | 10/22/2008
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Last Update Date | 08/31/2010
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Provider Practice Location Address
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Address Line | 6776 SOUTHWEST FWY STE 175
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City | HOUSTON
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State | TX
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Zip | 77074-2109
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Country | US
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Telephone | 713-953-7354
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Fax | 713-977-4673
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Provider Business Mailing Address
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Address Line | 6776 SOUTHWEST FWY STE 175
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City | HOUSTON
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State | TX
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Zip | 77074-2111
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Country | US
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Telephone | 713-953-7354
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Fax | 713-977-4673
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Authorized Official
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Title or Position | PRESIDENT CEO
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Name | SANDRA A PONCE
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Credential |
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Telephone | 713-953-7354
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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