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General NPI Number Information
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NPI Number | 1386387553
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Entity Type | Organization
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Legal Business Name | MMM ECORP, INC
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Dates
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Enumeration Date | 04/15/2022
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Last Update Date | 02/21/2023
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Provider Practice Location Address
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Address Line | 6590 SOUTHWEST FWY STE B
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City | HOUSTON
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State | TX
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Zip | 77074-2216
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Country | US
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Telephone | 713-993-6219
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Fax |
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Provider Business Mailing Address
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Address Line | 12219 MEADOW LANE CT
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City | MEADOWS PLACE
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State | TX
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Zip | 77477-2254
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Country | US
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Telephone | 281-690-1312
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MAYET SAN LUIS MOHAMMED
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Credential | RRT
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Telephone | 713-993-6219
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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