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General NPI Number Information
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NPI Number | 1831473933
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Entity Type | Organization
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Legal Business Name | SUPERIOR CHOICE MEDICAL SERVICES INC.
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Dates
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Enumeration Date | 10/06/2011
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Last Update Date | 06/18/2012
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Provider Practice Location Address
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Address Line | 11000 S WILCREST DR STE 130
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City | HOUSTON
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State | TX
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Zip | 77099-4355
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Country | US
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Telephone | 832-230-0078
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Fax | 832-201-7712
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Provider Business Mailing Address
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Address Line | 11000 S WILCREST DR STE 130
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City | HOUSTON
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State | TX
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Zip | 77099-4355
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Country | US
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Telephone | 832-230-0078
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Fax | 832-201-7712
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Authorized Official
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Title or Position | CEO
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Name | STACEY MACFARLANE
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Credential |
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Telephone | 310-482-0084
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number |
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License Number State |
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