Provider Demographics
NPI:1033466719
Name:INNATE ABILITY LLC
Entity Type:Organization
Organization Name:INNATE ABILITY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:Q
Authorized Official - Last Name:HARPER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:830-964-3032
Mailing Address - Street 1:1742 FM 2673
Mailing Address - Street 2:
Mailing Address - City:CANYON LAKE
Mailing Address - State:TX
Mailing Address - Zip Code:78133-4743
Mailing Address - Country:US
Mailing Address - Phone:830-964-3032
Mailing Address - Fax:830-964-4460
Practice Address - Street 1:1742 FM 2673
Practice Address - Street 2:
Practice Address - City:CANYON LAKE
Practice Address - State:TX
Practice Address - Zip Code:78133-4743
Practice Address - Country:US
Practice Address - Phone:830-964-3032
Practice Address - Fax:830-964-4460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-13
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11974261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care