Provider Demographics
NPI:1003161985
Name:COMMUNITY BIRTH SERVICES, LLC
Entity Type:Organization
Organization Name:COMMUNITY BIRTH SERVICES, LLC
Other - Org Name:MAGNOLIA BIRTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GHALY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-469-0093
Mailing Address - Street 1:12850 JONES RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4955
Mailing Address - Country:US
Mailing Address - Phone:281-469-0093
Mailing Address - Fax:
Practice Address - Street 1:12850 JONES RD
Practice Address - Street 2:SUITE 105
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4955
Practice Address - Country:US
Practice Address - Phone:281-469-0093
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-17
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX150022261QB0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing