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General NPI Number Information
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NPI Number | 1518306661
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Entity Type | Organization
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Legal Business Name | MD HOUSECALLS GROUP
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Dates
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Enumeration Date | 06/21/2013
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Last Update Date | 06/21/2013
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Provider Practice Location Address
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Address Line | 1805 WYLIE CREEK DR
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City | DESOTO
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State | TX
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Zip | 75115-1729
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Country | US
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Telephone | 866-616-9334
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Fax | 972-230-1390
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Provider Business Mailing Address
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Address Line | PO BOX 321
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City | CEDAR HILL
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State | TX
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Zip | 75106-0321
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Country | US
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Telephone | 866-616-9334
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Fax | 972-230-1390
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Authorized Official
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Title or Position | PRESIDENT/COO
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Name | MS. ALEMETA B BRADLEY
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Credential | CMC
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Telephone | 469-556-6061
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State | NULL
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number |
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License Number State | NULL
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Taxonomy #3
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Taxonomy Code | 164X00000X
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Taxonomy Name | Licensed Vocational Nurse
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License Number |
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License Number State | NULL
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