Healthcare Provider Details

I. General information

NPI: 1417188095
Provider Name (Legal Business Name): LD HEALTHCARE SYSTEMS, CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2009
Last Update Date: 07/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5847 SAN FELIPE ST STE.1730
HOUSTON TX
77057-3000
US

IV. Provider business mailing address

2100 TANNEHILL DR STE. 2093
HOUSTON TX
77008-3125
US

V. Phone/Fax

Practice location:
  • Phone: 832-641-5179
  • Fax: 530-420-4260
Mailing address:
  • Phone: 832-641-5179
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QC1800X
TaxonomyCorporate Health Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QG0250X
TaxonomyGenetics Clinic/Center
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. LUBA EUGENIA DIANGAR
Title or Position: VP/TREASURER
Credential:
Phone: 832-641-5179