Accountable Source

NPI 1134496532 - Exclusive Provider Organization - 302F00000X

NPI Details
NPI 1134496532
Enumeration Date 11/30/2011
Last Updated 11/30/2011
Entity Type Healthcare Provider
Active Over 5 years ago
Authorized Information
Name GULLESE D GULLESE
Position PRESIDENT
Phone (832) 212-2131
Fax
Practice Location
3737 MANGUM RD STE A
HOUSTON TX, 77092-5407, US
Phone (832) 212-2131
Fax
Business Location
3737 MANGUM RD STE A
HOUSTON TX, 77092-5407, US
Phone (832) 212-2131
Fax
Toxanomy
Taxonomy Code 302F00000X
License State Texas
License Number 0000
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According to our database, Accountable Source NPI is 1134496532, taxonomy code is 302F00000X and license number is 0000, license state is located at Texas. Accountable Source physically located at 3737 Mangum Rd Ste A, Houston TX, 77092-5407. NPI Number 1033115704 has the healthcare provider type.

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1134496532 NPI number is provided on an as is basis without warranty of any kind. 1134496532 is maintained by the National Plan & Provider Enumeration System. The contents of Accountable Source are for informational purposes only.