Provider Demographics
NPI:1154065936
Name:DOC DOE CONSULTANTS, LLC
Entity Type:Organization
Organization Name:DOC DOE CONSULTANTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING OFFICER
Authorized Official - Prefix:MISS
Authorized Official - First Name:DAISY
Authorized Official - Middle Name:
Authorized Official - Last Name:CERVANTES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-704-6272
Mailing Address - Street 1:363 N SAM HOUSTON PKWY E STE 1100
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77060-2413
Mailing Address - Country:US
Mailing Address - Phone:832-704-6272
Mailing Address - Fax:832-553-8031
Practice Address - Street 1:363 N SAM HOUSTON PKWY E STE 1100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-2413
Practice Address - Country:US
Practice Address - Phone:832-704-6272
Practice Address - Fax:832-553-8031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-26
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Multi-Specialty