Provider Demographics
NPI: | 1184980534 |
---|---|
Name: | SELECT QUALITY MEDICAL SERVICES |
Entity type: | Organization |
Organization Name: | SELECT QUALITY MEDICAL SERVICES |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | ADMINISTRATOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | MARY |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | MCNEIL |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 832-483-4064 |
Mailing Address - Street 1: | 6200 GULF FREEWAY |
Mailing Address - Street 2: | |
Mailing Address - City: | HOUSTON |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 77023 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 832-483-4064 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 6200 GULF FREEWAY |
Practice Address - Street 2: | |
Practice Address - City: | HOUSTON |
Practice Address - State: | TX |
Practice Address - Zip Code: | 77023 |
Practice Address - Country: | US |
Practice Address - Phone: | 832-483-4064 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2012-04-10 |
Last Update Date: | 2012-04-10 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center | |
No | 261QA0005X | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Family Planning Facility |
No | 261QA0600X | Ambulatory Health Care Facilities | Clinic/Center | Adult Day Care |
No | 261QC1500X | Ambulatory Health Care Facilities | Clinic/Center | Community Health |
No | 261QF0400X | Ambulatory Health Care Facilities | Clinic/Center | Federally Qualified Health Center (FQHC) |
No | 261QH0100X | Ambulatory Health Care Facilities | Clinic/Center | Health Service |
No | 261QH0700X | Ambulatory Health Care Facilities | Clinic/Center | Hearing and Speech |
No | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |
No | 261QM0850X | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health |
No | 261QM0855X | Ambulatory Health Care Facilities | Clinic/Center | Adolescent and Children Mental Health |
No | 261QM2500X | Ambulatory Health Care Facilities | Clinic/Center | Medical Specialty |
No | 261QP2000X | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy |
No | 261QR0401X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
No | 261QR0405X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder |
No | 261QV0200X | Ambulatory Health Care Facilities | Clinic/Center | VA |