Organization
MEMORIAL VILLAGE SPECIALTY PHYSICIANS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANITA M DOOLY (CREDENTIALING SPECIALIST)
(832) 699-3777
Entity
Organization
Contact information
Practice address
14520 MEMORIAL DR STE 4, HOUSTON, TX 77079-5415
(281) 496-6837
Mailing address
1710 S DAIRY ASHFORD RD STE 109, HOUSTON, TX 77077-3859
(832) 699-3777
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
207P00000X
Emergency Medicine Physician
—
—
Other
Enumeration date
08/11/2017
Last updated
08/11/2017
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