Provider Demographics
| NPI: | 1184980534 |
|---|---|
| Name: | SELECT QUALITY MEDICAL SERVICES |
| Entity type: | Organization |
| Organization Name: | SELECT QUALITY MEDICAL SERVICES |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | ADMINISTRATOR |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | MARY |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | MCNEIL |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 832-483-4064 |
| Mailing Address - Street 1: | 6200 GULF FREEWAY |
| Mailing Address - Street 2: | |
| Mailing Address - City: | HOUSTON |
| Mailing Address - State: | TX |
| Mailing Address - Zip Code: | 77023 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 832-483-4064 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 6200 GULF FREEWAY |
| Practice Address - Street 2: | |
| Practice Address - City: | HOUSTON |
| Practice Address - State: | TX |
| Practice Address - Zip Code: | 77023 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 832-483-4064 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2012-04-10 |
| Last Update Date: | 2012-04-10 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center | |
| No | 261QA0005X | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Family Planning Facility |
| No | 261QA0600X | Ambulatory Health Care Facilities | Clinic/Center | Adult Day Care |
| No | 261QC1500X | Ambulatory Health Care Facilities | Clinic/Center | Community Health |
| No | 261QF0400X | Ambulatory Health Care Facilities | Clinic/Center | Federally Qualified Health Center (FQHC) |
| No | 261QH0100X | Ambulatory Health Care Facilities | Clinic/Center | Health Service |
| No | 261QH0700X | Ambulatory Health Care Facilities | Clinic/Center | Hearing and Speech |
| No | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |
| No | 261QM0850X | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health |
| No | 261QM0855X | Ambulatory Health Care Facilities | Clinic/Center | Adolescent and Children Mental Health |
| No | 261QM2500X | Ambulatory Health Care Facilities | Clinic/Center | Medical Specialty |
| No | 261QP2000X | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy |
| No | 261QR0401X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| No | 261QR0405X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder |
| No | 261QV0200X | Ambulatory Health Care Facilities | Clinic/Center | VA |