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NPI Code Detail

MEDICARE: SUPERIOR CHOICE MEDICAL SERVICES INC.

MEDICARE: SUPERIOR CHOICE MEDICAL SERVICES INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TB0200XCognitive & Behavioral Psychologist

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1833AOTHERTXMEDICARE PART A/B AND MEDICIAD

General Provider Information

NPI Number : 1831473933
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUPERIOR CHOICE MEDICAL SERVICES INC.
Provider Business Mailing Address
First Line : 11000 S WILCREST DR
Second Line : STE 130
City : HOUSTON
State : TX
Zip : 77099-4355
Country : US
Telephone Number : 832-230-0078
Fax Number : 832-201-7712
Provider Business Practice Location Address
First Line : 11000 S WILCREST DR
Second Line : STE 130
City : HOUSTON
State : TX
Zip : 77099-4355
Country : US
Telephone Number : 832-230-0078
Fax Number : 832-201-7712
Authorized Official
Title or Position : CEO
Name : STACEY MACFARLANE
Credential :
Telephone Number : 310-482-0084
Provider Enumeration Date : 10/06/2011
Last Update Date : 06/18/2012

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