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General NPI Number Information
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NPI Number | 1902107808
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Entity Type | Organization
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Legal Business Name | MGB MINISTRY
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Dates
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Enumeration Date | 11/09/2010
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Last Update Date | 11/09/2010
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Provider Practice Location Address
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Address Line | 1930 FERGUS PARK CT
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City | HOUSTON
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State | TX
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Zip | 77047-7524
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Country | US
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Telephone | 713-434-7664
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Fax | 713-807-9082
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Provider Business Mailing Address
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Address Line | 1930 FERGUS PARK CT
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City | HOUSTON
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State | TX
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Zip | 77047-7524
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Country | US
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Telephone | 713-434-7664
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Fax | 713-807-9082
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Authorized Official
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Title or Position | OWNER
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Name | MR. MICHAEL GERHARD BURNS
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Credential |
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Telephone | 713-434-7664
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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