Provider Demographics
NPI:1467818831
Name:BELLAIRE RAPID RESPONSE TEAM, LLC
Entity Type:Organization
Organization Name:BELLAIRE RAPID RESPONSE TEAM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FACILITY ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DARRELL
Authorized Official - Middle Name:
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:346-477-4686
Mailing Address - Street 1:PO BOX 4093
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77347-9893
Mailing Address - Country:US
Mailing Address - Phone:346-477-4686
Mailing Address - Fax:
Practice Address - Street 1:3905 RICHMOND AVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-5803
Practice Address - Country:US
Practice Address - Phone:346-477-4686
Practice Address - Fax:713-583-9591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-14
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care