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General NPI Number Information
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NPI Number | 1487831236
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Entity Type | Organization
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Legal Business Name | MEDICAL DIAGNOSTIC CONSULTANTS PA
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Dates
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Enumeration Date | 01/23/2008
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Last Update Date | 06/18/2008
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Provider Practice Location Address
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Address Line | 5900 MEMORIAL DR STE 215
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City | HOUSTON
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State | TX
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Zip | 77007-8030
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Country | US
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Telephone | 713-861-4114
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Fax | 281-605-1966
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Provider Business Mailing Address
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Address Line | PO BOX 980308
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City | HOUSTON
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State | TX
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Zip | 77098-0308
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Country | US
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Telephone | 713-861-4114
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Fax | 281-605-1966
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. ANGELIA D KOLENDA
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Credential |
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Telephone | 713-861-4114
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number |
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License Number State |
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