Provider Demographics
NPI:1659748200
Name:50 PULMONARY SYSTEMS INTEGRATED
Entity Type:Organization
Organization Name:50 PULMONARY SYSTEMS INTEGRATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AQUINAS
Authorized Official - Middle Name:CHERI
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:RCP, RRT-NPS
Authorized Official - Phone:713-806-2095
Mailing Address - Street 1:10838 KIRKTOWN DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77089-3029
Mailing Address - Country:US
Mailing Address - Phone:832-308-0010
Mailing Address - Fax:
Practice Address - Street 1:8822 BASKOVE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77088-1435
Practice Address - Country:US
Practice Address - Phone:832-308-0010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-31
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX227900000X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredGroup - Single Specialty
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & SuppliesGroup - Single Specialty