Mda Diversified Enterprises Corp

NPI #1598347890 in Porter, Texas

Provider Information

NPI Number
1598347890
Entity Type
Organization
Organization Name
Mda Diversified Enterprises Corp
Primary Specialty
Nurse Practitioner
Enumeration Date
Apr 26, 2021
Last Updated
Apr 26, 2021

Practice Location

Address
23527 FM 1314 RD STE E
City
Porter
State
Texas
ZIP Code
77365-3724
Phone
(281) 381-6190

Authorized Official

Name
BETTY BROWN
Title
CREDENTIAL/BILLER
Phone
(281) 556-1298

Specialties & Taxonomy Codes

Specialty
General Practice
Nurse Practitioner

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