Provider Demographics
NPI:1215345293
Name:MOBILE HEALTH CHECK
Entity type:Organization
Organization Name:MOBILE HEALTH CHECK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GLENDADALE
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-445-9199
Mailing Address - Street 1:9816 MEMORIAL BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-4205
Mailing Address - Country:US
Mailing Address - Phone:281-446-0061
Mailing Address - Fax:
Practice Address - Street 1:9816 MEMORIAL BLVD STE 105
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-4205
Practice Address - Country:US
Practice Address - Phone:281-446-0061
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-23
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6853310001Medicare UPIN