Provider Demographics
NPI:1952565178
Name:ALPHA AUDIO VISUAL EQUIPMENT
Entity Type:Organization
Organization Name:ALPHA AUDIO VISUAL EQUIPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BURT
Authorized Official - Middle Name:
Authorized Official - Last Name:LANCASTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-483-0711
Mailing Address - Street 1:16307 COVEY RUN CT
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77489-5721
Mailing Address - Country:US
Mailing Address - Phone:832-483-0711
Mailing Address - Fax:
Practice Address - Street 1:16307 COVEY RUN CT
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77489-5721
Practice Address - Country:US
Practice Address - Phone:832-483-0711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALPHA AUDIO VISUAL EQUIPMENT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service