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General NPI Number Information
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NPI Number | 1467608596
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Entity Type | Organization
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Legal Business Name | BLOC MEDI CORP
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Dates
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Enumeration Date | 08/08/2008
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Last Update Date | 09/04/2008
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Provider Practice Location Address
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Address Line | 5555 WEST LOOP S STE 350
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City | BELLAIRE
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State | TX
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Zip | 77401-2100
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Country | US
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Telephone | 713-715-4800
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Fax | 713-715-4840
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Provider Business Mailing Address
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Address Line | 5555 WEST LOOP S STE 350
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City | BELLAIRE
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State | TX
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Zip | 77401-2100
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Country | US
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Telephone | 713-715-4800
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Fax | 713-715-4840
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. WARREN D CROSS JR.
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Credential | M.D.
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Telephone | 713-666-4224
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 801013885
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License Number State | TX
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