Provider Demographics
NPI:1700024312
Name:THE ORDER OF LOVE PEACE TRUTH TOLERANCE AND COOPERATION
Entity Type:Organization
Organization Name:THE ORDER OF LOVE PEACE TRUTH TOLERANCE AND COOPERATION
Other - Org Name:TBT CO-OP CLINICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TRUSTEE
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:H
Authorized Official - Last Name:MCCORMICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-202-9922
Mailing Address - Street 1:PO BOX 62230
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77205-2230
Mailing Address - Country:US
Mailing Address - Phone:832-202-9922
Mailing Address - Fax:866-234-8707
Practice Address - Street 1:14006 OLD HIGHWAY 59 N
Practice Address - Street 2:
Practice Address - City:SPLENDORA
Practice Address - State:TX
Practice Address - Zip Code:77372-6302
Practice Address - Country:US
Practice Address - Phone:832-202-9922
Practice Address - Fax:866-234-8707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-04
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty