Provider Demographics
NPI:1477961456
Name:COMPLETE CONSTRUCTION AND DESIGN
Entity Type:Organization
Organization Name:COMPLETE CONSTRUCTION AND DESIGN
Other - Org Name:UNIVERSAL PREMIER PRODUCTS AND SERVICES (UPPS)
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
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 1:9002 STERLINGSHIRE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77078-3018
Mailing Address - Country:US
Mailing Address - Phone:800-596-1250
Mailing Address - Fax:281-987-9362
Practice Address - Street 1:9002 STERLINGSHIRE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77078-3018
Practice Address - Country:US
Practice Address - Phone:800-596-1250
Practice Address - Fax:281-987-9362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-23
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX573231041C0700X
TX9035111N00000X
TX208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty