Provider Demographics
NPI:1760729727
Name:Q.C. MEDICAL CLINIC AND ASSOCIATES
Entity Type:Organization
Organization Name:Q.C. MEDICAL CLINIC AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-518-1745
Mailing Address - Street 1:2601 S BRAESWOOD BLVD
Mailing Address - Street 2:1004
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-2800
Mailing Address - Country:US
Mailing Address - Phone:713-518-1745
Mailing Address - Fax:866-544-3183
Practice Address - Street 1:2601 S BRAESWOOD BLVD
Practice Address - Street 2:1004
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77025-2800
Practice Address - Country:US
Practice Address - Phone:713-518-1745
Practice Address - Fax:866-544-3183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-11
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare