Provider Demographics
NPI:1013035732
Name:NISAL CORPORATION
Entity Type:Organization
Organization Name:NISAL CORPORATION
Other - Org Name:QUALCARE MEDICAL & REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:CCS
Authorized Official - Phone:832-428-2963
Mailing Address - Street 1:3915 SHAVER ST
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77504-2603
Mailing Address - Country:US
Mailing Address - Phone:713-378-0030
Mailing Address - Fax:713-378-0399
Practice Address - Street 1:3915 SHAVER ST
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77504-2603
Practice Address - Country:US
Practice Address - Phone:713-378-0030
Practice Address - Fax:713-378-0399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty