Provider Demographics
NPI:1508069550
Name:POTENTIAL MEDICAL SERVICES, LP
Entity Type:Organization
Organization Name:POTENTIAL MEDICAL SERVICES, LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT,OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-698-8500
Mailing Address - Street 1:519 E INTERSTATE 30
Mailing Address - Street 2:SUITE 308
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087-5408
Mailing Address - Country:US
Mailing Address - Phone:469-698-8500
Mailing Address - Fax:469-698-8504
Practice Address - Street 1:519 E I30
Practice Address - Street 2:SUITE 308
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087-5408
Practice Address - Country:US
Practice Address - Phone:469-698-8500
Practice Address - Fax:469-698-8504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherGroup - Single Specialty