Provider Demographics
NPI:1295056877
Name:PCCSS, PLLC.
Entity type:Organization
Organization Name:PCCSS, PLLC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARSHAY
Authorized Official - Middle Name:S
Authorized Official - Last Name:METOYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-988-0850
Mailing Address - Street 1:7500 BEECHNUT ST.
Mailing Address - Street 2:STE. 250
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-4396
Mailing Address - Country:US
Mailing Address - Phone:713-988-0850
Mailing Address - Fax:713-988-0866
Practice Address - Street 1:7500 BEECHNUT ST.
Practice Address - Street 2:STE. 250
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-4396
Practice Address - Country:US
Practice Address - Phone:713-988-0850
Practice Address - Fax:713-988-0866
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PCCSS, LLP.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-06-17
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB126665Medicaid
TX284404501Medicaid
TX284404502Medicaid
TX284404502Medicaid