Organization
ELITE MEDICAL CREDENTIALING & CONSULTING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LITA MICHELE WILLIS (OWNER/SENIOR SERVICE REPRESENTATIVE)
(281) 753-6936
Entity
Organization
Contact information
Practice address
1411 CHERRY SPRINGS CT, MISSOURI CITY, TX 77459-3469
(281) 753-6936
(281) 753-6936
Mailing address
PO BOX 57712, WEBSTER, TX 77598-7712
(281) 753-6936
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
B566406
TX
Other
Enumeration date
09/29/2017
Last updated
09/29/2017
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