Provider Demographics
NPI:1376729152
Name:MPULSE HEALTHCARE
Entity Type:Organization
Organization Name:MPULSE HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:MR
Authorized Official - First Name:TYRONE
Authorized Official - Middle Name:
Authorized Official - Last Name:DIXON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-277-4410
Mailing Address - Street 1:54 SUGAR CREEK CENTER BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4064
Mailing Address - Country:US
Mailing Address - Phone:281-277-4410
Mailing Address - Fax:281-605-5598
Practice Address - Street 1:4173 BLUEBONNET DR
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-3909
Practice Address - Country:US
Practice Address - Phone:281-277-4410
Practice Address - Fax:281-605-5598
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-11
Last Update Date:2012-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6443520001Medicare NSC