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General NPI Number Information
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NPI Number | 1477069995
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Entity Type | Organization
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Legal Business Name | MODERN MED HEALTH SOLUTIONS LLC
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Dates
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Enumeration Date | 12/20/2017
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Last Update Date | 08/04/2018
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Provider Practice Location Address
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Address Line | 9950 WESTPARK DR STE 312
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City | HOUSTON
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State | TX
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Zip | 77063
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Country | US
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Telephone | 713-936-4949
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Fax | 713-936-4949
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Provider Business Mailing Address
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Address Line | 9950 WESTPARK DR STE 312
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City | HOUSTON
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State | TX
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Zip | 77063-5371
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Country | US
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Telephone | 713-936-4949
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Fax | 713-936-4949
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Authorized Official
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Title or Position | NURSE PRACTITIONER/ CO OWNER
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Name | MANOUCHCAR PIERRE-VAL
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Credential | ARNP
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Telephone | 888-753-3824
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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