Provider Demographics
NPI:1164839478
Name:COMPLETE CONSTRUCTION AND DESIGN
Entity Type:Organization
Organization Name:COMPLETE CONSTRUCTION AND DESIGN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:IVORY
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYHORN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:800-596-1250
Mailing Address - Street 1:9723 HOMESTEAD RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77016-4403
Mailing Address - Country:US
Mailing Address - Phone:800-596-1250
Mailing Address - Fax:800-918-6970
Practice Address - Street 1:9723 HOMESTEAD RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77016-4403
Practice Address - Country:US
Practice Address - Phone:800-596-1250
Practice Address - Fax:800-918-6970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-18
Last Update Date:2014-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX573231041C0700X
TX9035111N00000X
208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty