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Organization
QLMPROFILE LLC
Active
Organization
QLMPROFILE LLC
Active
Other names
Quality Life Medical
Organization subpart
No
Provider details
NPI number
Authorized official
NOVARRO C STAFFORD MD (MEDICAL DIRECTOR)
(832) 298-6380
Entity
Organization
Contact information
Practice address
14405 WALTERS RD, HOUSTON, TX 77014-1337
(832) 401-9407
(832) 965-5111
Mailing address
14405 WALTERS RD, HOUSTON, TX 77014-1337
(832) 401-9407
(832) 965-5111
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
H5072
TX
Other
Enumeration date
08/10/2015
Last updated
08/10/2015
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