Md1961 LLC

NPI #1780150995 in Baytown, Texas

Provider Information

NPI Number: 1780150995
Entity Type: Organization
Organization Name: Md1961 LLC
Primary Specialty: Surgery
Enumeration Date: Oct 16, 2018
Last Updated: Oct 16, 2018

Practice Location

Address: 4201 GARTH RD STE 301
City: Baytown
State: Texas
ZIP Code: 77521-3156
Phone: (281) 422-9811

Authorized Official

Name: CARLA PINA
Title: OWNER
Phone: (281) 422-9811

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Surgery	208600000X	Primary

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