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General NPI Number Information
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NPI Number | 1720385115
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Entity Type | Organization
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Legal Business Name | EXPERIENCE INFUSION CENTERS, LLC
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Dates
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Enumeration Date | 02/21/2011
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Last Update Date | 02/21/2011
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Provider Practice Location Address
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Address Line | 6300 RICHMOND AVE SUITE 101
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City | HOUSTON
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State | TX
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Zip | 77057-5931
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Country | US
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Telephone | 832-582-8919
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Fax | 832-582-8924
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Provider Business Mailing Address
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Address Line | 6300 RICHMOND AVE SUITE 101
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City | HOUSTON
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State | TX
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Zip | 77057-5931
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Country | US
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Telephone | 832-582-8919
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Fax | 832-582-8924
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Authorized Official
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Title or Position | PRES/CEO
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Name | MR. JIM RUTHERFORD
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Credential |
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Telephone | 832-582-8919
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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