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General NPI Number Information
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NPI Number | 1437837556
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Entity Type | Organization
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Legal Business Name | 180 MEDICAL CLINIC INC
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Dates
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Enumeration Date | 07/10/2023
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Last Update Date | 07/10/2023
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Provider Practice Location Address
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Address Line | 2580 FM 1960 RD W STE D
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City | HOUSTON
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State | TX
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Zip | 77068-3706
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Country | US
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Telephone | 281-919-1476
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Fax | 877-288-1193
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Provider Business Mailing Address
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Address Line | 2580 FM 1960 RD W STE D
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City | HOUSTON
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State | TX
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Zip | 77068-3706
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Country | US
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Telephone | 281-919-1476
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Fax | 877-288-1193
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. VIRAF COOPER
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Credential | MD
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Telephone | 281-919-1476
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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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 | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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Taxonomy #3
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Taxonomy Code | 332S00000X
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Taxonomy Name | Hearing Aid Equipment
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License Number |
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Taxonomy #4
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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Taxonomy #5
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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Taxonomy #6
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Taxonomy Code | 261QF0050X
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Taxonomy Name | Non-Surgical Family Planning Clinic/Center
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License Number |
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Taxonomy #7
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Taxonomy Code | 261QM1100X
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Taxonomy Name | Military/U.S. Coast Guard Outpatient Clinic/Center
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License Number |
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Taxonomy #8
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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Taxonomy #9
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Taxonomy Code | 261QP2400X
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Taxonomy Name | Prison Health Clinic/Center
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License Number |
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Taxonomy #10
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number |
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Taxonomy #11
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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Taxonomy #12
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Taxonomy Code | 332BD1200X
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Taxonomy Name | Dialysis Equipment & Supplies (DME)
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License Number |
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Taxonomy #13
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Taxonomy Code | 332BN1400X
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Taxonomy Name | Nursing Facility Supplies (DME)
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License Number |
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Taxonomy #14
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number |
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Taxonomy #15
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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