Provider Demographics
NPI:1629683891
Name:MED IV LLC
Entity Type:Organization
Organization Name:MED IV LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROPHAIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-679-4487
Mailing Address - Street 1:PO BOX 131257
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77393-1257
Mailing Address - Country:US
Mailing Address - Phone:346-201-5743
Mailing Address - Fax:346-396-2269
Practice Address - Street 1:23510 KINGSLAND BLVD STE 101
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-4126
Practice Address - Country:US
Practice Address - Phone:346-201-5743
Practice Address - Fax:346-396-2269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-14
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy