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General NPI Number Information
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NPI Number | 1598972846
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Entity Type | Organization
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Legal Business Name | MDRELIANCE INC.
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 01/29/2008
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Provider Practice Location Address
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Address Line | 5858 WESTHEIMER RD SUITE 306
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City | HOUSTON
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State | TX
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Zip | 77057-5650
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Country | US
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Telephone | 832-295-0921
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Fax | 713-334-2528
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Provider Business Mailing Address
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Address Line | 5858 WESTHEIMER RD SUITE 400
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City | HOUSTON
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State | TX
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Zip | 77057-5650
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Country | US
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Telephone | 832-519-1539
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Fax | 713-334-2528
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Authorized Official
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Title or Position | DIRECTOR OF CREDENTIALING
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Name | VALERIE D VERA
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Credential |
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Telephone | 832-519-1539
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number | K7693
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License Number State | TX
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