Provider Demographics
NPI:1568480127
Name:MRC TOWNCREEK
Entity type:Organization
Organization Name:MRC TOWNCREEK
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:M
Authorized Official - Last Name:BERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-363-2600
Mailing Address - Street 1:1115 AVENUE O
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77340-4443
Mailing Address - Country:US
Mailing Address - Phone:936-295-0216
Mailing Address - Fax:936-291-2907
Practice Address - Street 1:1115 AVENUE O
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77340-4443
Practice Address - Country:US
Practice Address - Phone:936-295-0216
Practice Address - Fax:936-291-2907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010009251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health