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General NPI Number Information
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NPI Number | 1730585159
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Entity Type | Organization
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Legal Business Name | LIBERTY COUNTY PHYSICIAN SERVICES
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Dates
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Enumeration Date | 11/12/2014
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Last Update Date | 07/13/2015
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Provider Practice Location Address
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Address Line | 25440 I-45 NORTH SUITE 100
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City | SPRING
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State | TX
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Zip | 77386
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Country | US
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Telephone | 281-602-8160
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Fax | 281-292-5504
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Provider Business Mailing Address
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Address Line | 25410 I H 45
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City | SPRING
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State | TX
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Zip | 77386-1351
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Country | US
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Telephone | 832-722-8283
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Fax | 281-292-5504
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Authorized Official
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Title or Position | REVENUE CYCLE COORDINATOR
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Name | MS. RAYLENE M ATKINSON
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Credential |
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Telephone | 832-722-8283
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | L8339
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License Number State | TX
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