Basic Information
| Provider Information | |||||||||
| NPI: | 1427328673 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | RAYFORD ER MANAGEMENT COMPANY LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 25440 I-45 NORTH | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | SPRING | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773861343 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2814191599 | ||||||||
| FaxNumber: | 2814195885 | ||||||||
| Practice Location | |||||||||
| Address1: | 25440 INTERSTATE 45 | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | SPRING | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773861343 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2814191599 | ||||||||
| FaxNumber: | 2814195885 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/05/2012 | ||||||||
| LastUpdateDate: | 01/05/2012 | ||||||||
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| AuthorizedOfficialLastName: | MOPARTY | ||||||||
| AuthorizedOfficialFirstName: | RAVI | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 2814191599 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 146L00000X | L2481 | TX | Y | 193200000X MULTI-SPECIALTY GROUP | Emergency Medical Service Providers | Emergency Medical Technician, Paramedic |
No ID Information.