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General NPI Number Information
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NPI Number | 1811372683
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Entity Type | Organization
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Legal Business Name | SUPERIOR PAC
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Dates
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Enumeration Date | 07/22/2015
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Last Update Date | 07/22/2015
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Provider Practice Location Address
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Address Line | 1302 WAUGH DR # 618
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City | HOUSTON
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State | TX
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Zip | 77019-3908
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Country | US
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Telephone | 281-661-7664
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Fax | 281-661-7665
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Provider Business Mailing Address
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Address Line | 1302 WAUGH DR # 618
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City | HOUSTON
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State | TX
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Zip | 77019-3908
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Country | US
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Telephone | 281-661-7664
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Fax | 281-661-7665
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Authorized Official
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Title or Position | OWNER
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Name | JAY ZEIDMAN
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Credential |
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Telephone | 281-661-7664
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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