MEDICARE: MEDICAL INTERMEDIARIES OF TEXAS LLC

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
1	246YC3302X	Physician Office Based Coding Specialist

General Provider Information

NPI Number	:	1861867327
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL INTERMEDIARIES OF TEXAS LLC

Provider Business Mailing Address
First Line	:	2601 WOODLAND PARK DR
Second Line	:	4214
City	:	HOUSTON
State	:	TX
Zip	:	77077-6161
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2601 WOODLAND PARK DR
Second Line	:	4214
City	:	HOUSTON
State	:	TX
Zip	:	77077-6161
Country	:	US
Telephone Number	:	832-461-9187
Fax Number	:

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	MESERET T MESFIN
Credential	:
Telephone Number	:	832-461-9187

Provider Enumeration Date	:	12/09/2015
Last Update Date	:	12/09/2015

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