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General NPI Number Information
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NPI Number | 1851071690
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Entity Type | Organization
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Legal Business Name | IMMUNOCINE, LLC
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Dates
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Enumeration Date | 07/18/2023
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Last Update Date | 04/23/2026
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Provider Practice Location Address
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Address Line | BOULEVARD LUIS DONALDO COLOSO (AV TULUM) MANZANA 1
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City | CANCUN
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State | Q.R.
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Zip | 77504
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Country | MX
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Telephone | 888-575-2572
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Fax |
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Provider Business Mailing Address
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Address Line | 3422 BUSINESS CENTER DR STE 106 #1123
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City | PEARLAND
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State | TX
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Zip | 77584-4159
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Country | US
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Telephone | 888-575-2572
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Fax | 832-827-4875
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Authorized Official
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Title or Position | CEO
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Name | DR. MATTHEW MARTIN HALPERT
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Credential | PHD
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Telephone | 832-814-2185
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RI0001X
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Taxonomy Name | Clinical & Laboratory Immunology (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number |
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License Number State |
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