Provider Demographics
NPI:1992049134
Name:CG INNOVATIVE HEALTHCARE SOLUTIONS
Entity type:Organization
Organization Name:CG INNOVATIVE HEALTHCARE SOLUTIONS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:DMIN, CCC, CPM
Authorized Official - Phone:877-454-5134
Mailing Address - Street 1:2600 S LOOP W
Mailing Address - Street 2:696
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2653
Mailing Address - Country:US
Mailing Address - Phone:877-454-5132
Mailing Address - Fax:713-838-8187
Practice Address - Street 1:2600 S LOOP W
Practice Address - Street 2:696
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2653
Practice Address - Country:US
Practice Address - Phone:877-454-5132
Practice Address - Fax:713-838-8187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-10
Last Update Date:2012-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)Group - Multi-Specialty