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General NPI Number Information
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NPI Number | 1801453691
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Entity Type | Organization
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Legal Business Name | MODIFIED ACCESS CONSTRUCTION, LLC
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Dates
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Enumeration Date | 05/28/2019
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Last Update Date | 05/28/2019
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Provider Practice Location Address
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Address Line | 928 E 53RD ST
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City | AUSTIN
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State | TX
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Zip | 78751-2246
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Country | US
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Telephone | 512-788-1016
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Fax |
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Provider Business Mailing Address
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Address Line | 928 E 53RD ST
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City | AUSTIN
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State | TX
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Zip | 78751-2246
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Country | US
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Telephone | 512-788-1016
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JOE VALDEZ
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Credential |
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Telephone | 512-788-1016
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171WH0202X
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Taxonomy Name | Home Modifications Contractor
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License Number |
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License Number State |
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