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General NPI Number Information
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NPI Number | 1851666218
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Entity Type | Organization
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Legal Business Name | HOLY MEDICAL MANAGEMENT SERVICES
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Dates
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Enumeration Date | 03/19/2012
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Last Update Date | 03/19/2012
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Provider Practice Location Address
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Address Line | 6910 CHETWOOD DR
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City | HOUSTON
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State | TX
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Zip | 77081-5612
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Country | US
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Telephone | 713-640-5559
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Fax | 832-433-7776
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Provider Business Mailing Address
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Address Line | 6910 CHETWOOD DR
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City | HOUSTON
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State | TX
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Zip | 77081-5612
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Country | US
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Telephone | 713-640-5559
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Fax | 832-433-7776
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | RAUL FASHE
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Credential | CEO
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Telephone | 713-640-5559
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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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 | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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