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Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. REGINALD SMITH (OWNER)
(713) 283-0049
Entity
Organization

Contact information

Practice address
11603 HILLCROFT ST, HOUSTON, TX 77035-2523
(713) 283-0049
(713) 283-0049
Mailing address
11603 HILLCROFT ST, HOUSTON, TX 77035-2523
(713) 283-0049
(713) 283-0049

Taxonomy

Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
464061423
SS#
TX
Enumeration date
06/12/2008
Last updated
06/12/2008
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