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General NPI Number Information
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NPI Number | 1639505787
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Entity Type | Organization
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Legal Business Name | T.N. ELDRIDGE MANAGEMENT GROUP LIMITED PARTNERSHIP
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Dates
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Enumeration Date | 09/20/2013
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Last Update Date | 09/25/2013
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Provider Practice Location Address
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Address Line | 25222 NORTHWEST FWY 274
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City | CYPRESS
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State | TX
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Zip | 77429-1030
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Country | US
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Telephone | 832-797-5969
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Fax |
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Provider Business Mailing Address
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Address Line | 25222 NORTHWEST FWY 274
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City | CYPRESS
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State | TX
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Zip | 77429-1030
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Country | US
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Telephone | 832-797-5969
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TOJUNA ELDRIDGE
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Credential |
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Telephone | 832-797-5969
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State | TX
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