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General NPI Number Information
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NPI Number | 1306032057
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Entity Type | Organization
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Legal Business Name | SOUTHCARE GROUP LLC
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Dates
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Enumeration Date | 09/17/2007
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Last Update Date | 11/16/2007
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Provider Practice Location Address
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Address Line | 6750 WEST LOOP S STE 950
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City | BELLAIRE
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State | TX
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Zip | 77401-4124
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Country | US
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Telephone | 713-838-0800
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Fax | 713-838-0887
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Provider Business Mailing Address
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Address Line | 6750 WEST LOOP S STE 950
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City | BELLAIRE
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State | TX
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Zip | 77401-4124
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Country | US
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Telephone | 713-838-0800
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Fax | 713-838-0887
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. GARY S JANACEK
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Credential |
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Telephone | 281-795-4743
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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 | TX
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