Healthcare Provider Details

I. General information

NPI: 1699315861
Provider Name (Legal Business Name): HEALTHMED SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2020
Last Update Date: 01/15/2020
Certification Date: 01/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12808 VETERANS MEMORIAL DR
HOUSTON TX
77014-2004
US

IV. Provider business mailing address

12808 VETERANS MEMORIAL DR
HOUSTON TX
77014-2004
US

V. Phone/Fax

Practice location:
  • Phone: 281-687-3413
  • Fax: 281-255-3148
Mailing address:
  • Phone: 281-687-3413
  • Fax: 281-255-3148

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ANGELA OKOTIE-EBOH
Title or Position: PARTNER
Credential: DNP
Phone: 281-687-3413