Organization Name: | ESSENTIAL MEDICAL CONSULTANT |
NPI Number: | 1043595226 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TRACEY MARTIN WHITLEY (CEO/ PRESIDENT) |
Mailing Address: | 6300 West Loop S Ste 690 Bellaire |
State: | TX US |
Postal Code: | 774012915 |
Phone Number: | 2815012094 |
Fax Number: | 2815012107 |
NPI Enumeration Date: | 10/19/2011 |
NPI Last Update Date: | 10/19/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0208X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Radiology, Mobile |
Taxonomy Definition: |