Provider Demographics
NPI:1093040636
Name:REMOTE PHYSICIAN CONSULTING PA
Entity type:Organization
Organization Name:REMOTE PHYSICIAN CONSULTING PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELIA
Authorized Official - Middle Name:D
Authorized Official - Last Name:KOLENDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-380-3626
Mailing Address - Street 1:PO BOX 541957
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77254-1957
Mailing Address - Country:US
Mailing Address - Phone:832-380-3626
Mailing Address - Fax:866-681-8739
Practice Address - Street 1:5900 MEMORIAL DRIVE
Practice Address - Street 2:SUITE 214
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-8004
Practice Address - Country:US
Practice Address - Phone:832-380-3626
Practice Address - Fax:866-681-8739
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-15
Last Update Date:2009-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization