Healthcare Provider Details

I. General information

NPI: 1376964817
Provider Name (Legal Business Name): HS PROVIDERS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/31/2013
Last Update Date: 03/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4515 YOAKUM BLVD
HOUSTON TX
77006-5821
US

IV. Provider business mailing address

4515 YOAKUM BLVD
HOUSTON TX
77006-5821
US

V. Phone/Fax

Practice location:
  • Phone: 713-850-0049
  • Fax: 713-627-7302
Mailing address:
  • Phone: 713-850-0049
  • Fax: 713-627-7302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. LEO J. BORRELL
Title or Position: OWNER
Credential: M.D.
Phone: 713-850-0049