Provider Demographics
NPI:1740481225
Name:SEREL SERVICES, INC.
Entity type:Organization
Organization Name:SEREL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SERGIO
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNIZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-355-9007
Mailing Address - Street 1:26 MEDICAL DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-4129
Mailing Address - Country:US
Mailing Address - Phone:806-355-9007
Mailing Address - Fax:806-355-5147
Practice Address - Street 1:26 MEDICAL DR
Practice Address - Street 2:SUITE A
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-4129
Practice Address - Country:US
Practice Address - Phone:806-355-9007
Practice Address - Fax:806-355-5147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherEIN
TX00Y502Medicare PIN