Provider Demographics
NPI:1043595226
Name:ESSENTIAL MEDICAL CONSULTANT
Entity Type:Organization
Organization Name:ESSENTIAL MEDICAL CONSULTANT
Other - Org Name:ESSENTIAL MEDICAL DIAGNOSITCS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/ PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRACEY
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:WHITLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-501-2094
Mailing Address - Street 1:6300 WEST LOOP S STE 690
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-2915
Mailing Address - Country:US
Mailing Address - Phone:281-501-2094
Mailing Address - Fax:281-501-2107
Practice Address - Street 1:6300 WEST LOOP S STE 690
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-2915
Practice Address - Country:US
Practice Address - Phone:281-501-2094
Practice Address - Fax:281-501-2107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-19
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile