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General NPI Number Information
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NPI Number | 1457482226
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Entity Type | Organization
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Legal Business Name | EMERALD BLUE HEALTH CARE SERVICES,INC.
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 13206 INDIGO CREEK LN
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City | PEARLAND
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State | TX
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Zip | 77584-2548
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Country | US
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Telephone | 713-436-7498
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Fax | 713-436-7610
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Provider Business Mailing Address
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Address Line | 13206 INDIGO CREEK LN
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City | PEARLAND
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State | TX
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Zip | 77584-2548
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Country | US
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Telephone | 713-436-7498
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Fax | 713-436-7610
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | MS. MYTOIA C MOSS
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Credential | TX HEALTH CARE SERVI
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Telephone | 713-436-7498
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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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