Emerald Blue Health Care Services
Contractor in Houston, TX. Organization (NPI-2).
NPI number1043204530
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1043204530
- Entity type
- Organization (NPI-2)
- Legal business name
- Emerald Blue Health Care Services
- Organization subpart
- No
- Enumeration date
- Sep 9, 2005
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 171W00000X | Contractor | 001007771 | TX | Yes |
Other names
- Mytoia Moss (Doing Business As)
Practice location
822 Garden Trace LnHouston, TX 77018-6342
Phone 832-876-1360 · Fax 713-426-3603
Mailing address
822 Garden Trace LnHouston, TX 77018-6342
Phone 832-876-1360 · Fax 713-426-3603
Authorized official
Mytoia Moss
Owner/Program Director
8328761360
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