MEDICARE: FIRSTHAND HEALTH OF TEXAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1417610478
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIRSTHAND HEALTH OF TEXAS

Provider Business Mailing Address
First Line	:	205 HUDSON ST FL 8
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10013-1836
Country	:	US
Telephone Number	:	573-864-8733
Fax Number	:

Provider Business Practice Location Address
First Line	:	205 HUDSON ST FL 8
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10013-1836
Country	:	US
Telephone Number	:	573-864-8733
Fax Number	:

Authorized Official
Title or Position	:	INCORPORATOR
Name	:	DR. JOE PARKS
Credential	:	MD
Telephone Number	:	573-864-8733

Provider Enumeration Date	:	10/18/2021
Last Update Date	:	11/05/2021

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Directions to “FIRSTHAND HEALTH OF TEXAS ” Practice Location

Language	Start Address	Practice Location

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