Organization
INNOVATIVE R P INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY CARLISLE (OWNER)
(713) 218-7959
Entity
Organization
Contact information
Practice address
5535 MEMORIAL DR, STE F #325, HOUSTON, TX 77007
(713) 218-7959
Mailing address
5535 MEMORIAL DR, STE F #325, HOUSTON, TX 77007
(713) 218-7959
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0094392
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1000481
TEXAS DME LICENSE
TX
Enumeration date
04/09/2007
Last updated
10/26/2016
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