Provider Demographics
NPI:1871737460
Name:MC PROVIDER SERVICES LLC
Entity type:Organization
Organization Name:MC PROVIDER SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:JOHNSTONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-537-7976
Mailing Address - Street 1:3724 FM 1960, W.
Mailing Address - Street 2:STE. #224
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77068
Mailing Address - Country:US
Mailing Address - Phone:281-537-7976
Mailing Address - Fax:281-537-7976
Practice Address - Street 1:3724 FM 1960 W.
Practice Address - Street 2:STE. #224
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77068
Practice Address - Country:US
Practice Address - Phone:281-537-7976
Practice Address - Fax:281-537-7976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-27
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health