Provider Demographics
NPI:1982094967
Name:MATERNAL AND CHILD HEALTH SERVICES
Entity Type:Organization
Organization Name:MATERNAL AND CHILD HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MAGDALENE
Authorized Official - Middle Name:WILLIAMS
Authorized Official - Last Name:IKOTT
Authorized Official - Suffix:
Authorized Official - Credentials:RN CASE MANAGER
Authorized Official - Phone:281-736-9962
Mailing Address - Street 1:1303 RENE CT
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-5354
Mailing Address - Country:US
Mailing Address - Phone:281-736-9962
Mailing Address - Fax:
Practice Address - Street 1:1303 RENE CT
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-5354
Practice Address - Country:US
Practice Address - Phone:281-736-9962
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-29
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management