Provider Demographics
NPI:1124709142
Name:MAVERICK HEALTHCARE PLLC
Entity type:Organization
Organization Name:MAVERICK HEALTHCARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:281-730-7403
Mailing Address - Street 1:20407 NELLIE GAIL TRAIL LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-7429
Mailing Address - Country:US
Mailing Address - Phone:281-730-7403
Mailing Address - Fax:
Practice Address - Street 1:20407 NELLIE GAIL TRAIL LN
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-7429
Practice Address - Country:US
Practice Address - Phone:281-730-7403
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health