Provider Demographics
NPI:1962959510
Name:PRESTIGE MULTISERVICES MANAGEMENT CO, LLC
Entity type:Organization
Organization Name:PRESTIGE MULTISERVICES MANAGEMENT CO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DELIA
Authorized Official - Middle Name:LILA
Authorized Official - Last Name:SALINAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-656-5878
Mailing Address - Street 1:12000 RICHMOND AVE
Mailing Address - Street 2:SUITE 330
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-2428
Mailing Address - Country:US
Mailing Address - Phone:713-334-0530
Mailing Address - Fax:713-334-0552
Practice Address - Street 1:12000 RICHMOND AVE
Practice Address - Street 2:SUITE 330
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-2428
Practice Address - Country:US
Practice Address - Phone:713-334-0530
Practice Address - Fax:713-334-0552
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INTEGRA MEDICAL CLINIC PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-09-01
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No305S00000XManaged Care OrganizationsPoint of ServiceGroup - Multi-Specialty