Provider Demographics
NPI:1164799292
Name:INNOVATIVE MEDICAL ASSESSMENTS
Entity Type:Organization
Organization Name:INNOVATIVE MEDICAL ASSESSMENTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:RRT, RCP
Authorized Official - Phone:713-688-1161
Mailing Address - Street 1:5200 MITCHELLDALE ST STE E16
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77092-7222
Mailing Address - Country:US
Mailing Address - Phone:713-688-1161
Mailing Address - Fax:713-688-1312
Practice Address - Street 1:5200 MITCHELLDALE ST STE E16
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77092-7222
Practice Address - Country:US
Practice Address - Phone:713-688-1161
Practice Address - Fax:713-688-1312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-17
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory