Basic Information
| Provider Information | |||||||||
| NPI: | 1063008084 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RIGHT STEP MEDICAL CENTER LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6414 DIAMANTINA CT | ||||||||
| Address2: | |||||||||
| City: | KATY | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774937984 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2816503834 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11925 SOUTHWEST FWY STE 12 | ||||||||
| Address2: | |||||||||
| City: | STAFFORD | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774772300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2817419145 | ||||||||
| FaxNumber: | 8322300875 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/14/2020 | ||||||||
| LastUpdateDate: | 09/20/2022 | ||||||||
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| AuthorizedOfficialLastName: | PONRAJ | ||||||||
| AuthorizedOfficialFirstName: | JOBI | ||||||||
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| AuthorizedOfficialTitleorPosition: | MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 7138936214 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 09/20/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261Q00000X | N | Ambulatory Health Care Facilities | Clinic/Center | 261QM1300X | N | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty | 261QU0200X | Y | Ambulatory Health Care Facilities | Clinic/Center | Urgent Care |
No ID Information.