Provider Demographics
NPI:1982211892
Name:EPAT CONCIERGE MEDICALIS SERVICES
Entity Type:Organization
Organization Name:EPAT CONCIERGE MEDICALIS SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BUSINESS DEVELOPMENT
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELYN
Authorized Official - Middle Name:LETORY
Authorized Official - Last Name:BHONES
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RN
Authorized Official - Phone:832-661-8344
Mailing Address - Street 1:16920 KUYKENDAHL RD STE 229
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77068-1636
Mailing Address - Country:US
Mailing Address - Phone:281-591-4864
Mailing Address - Fax:
Practice Address - Street 1:16920 KUYKENDAHL RD STE 229
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77068-1636
Practice Address - Country:US
Practice Address - Phone:281-591-4864
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-24
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory